CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Cleveland Clinic Avon Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $509
Cash Discount Price: $820
vs. Medicare Baseline: 2.09x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Cleveland Clinic Avon Hospital is $509. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $820. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.09x the Medicare baseline. Located in 33300 Cleveland Clinic Blvd, Avon, OH.

Cash / Self-Pay

$820

Average discount available for prompt cash payment at this facility.

Insurance Median

$509

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $820 (336%)

Insurance Median: $509 (209%)

Cash: $820 (336% of Medicare)

Ins. Median: $509 (209% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 209% of the Medicare baseline (a markup of 109%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$127 - $1,008	52%
Buckeye	$127	52%
Molina	$127	52%
Caresource	$129	53%
United	$129 - $772	53%
Aetna	$224 - $1,261	92%
Devoted Health	$224	92%
Humana	$224	92%
Mmo	$224 - $677	92%
Summacare	$224 - $507	92%
The Health Plan	$224 - $757	92%
UnitedHealthcare	$224 - $782	92%
Upmc	$224 - $757	92%
Valor	$224	92%
Cigna	$231 - $657	95%
Communicare	$235	96%
Perennial Health	$242	99%
Pphp	$246	101%
Zing Health	$246	101%
Oscar	$380 - $485	156%
Cc Ehp	$503 - $511	206%
Aultcare	$542	222%
Amish Community Aid Plan	$567 - $630	233%
Ohcp	$613	251%
Omas	$630	258%
Ohio Healthy	$681	279%
Php	$757	311%
Gms	$883	362%
Medical Benefit Corp	$883	362%
Consociate Health	$946	388%
Frontpath	$1,135	466%
Managed Care Services	$1,135	466%
Multiplan	$1,135	466%
Tertiary Care Network	$1,135	466%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $820.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93970.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cleveland Clinic Avon Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93970.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.