CMS Price Transparency Data
Ultrasound, leg veins (duplex)
Facility: Prisma Health Oconee Memorial Hospital
Billing Code: 93970 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93970
- Insurance Median: $274
- Cash Discount Price: $1,145
- vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Prisma Health Oconee Memorial Hospital is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,145. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.12x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$1,145
Average discount available for prompt cash payment at this facility.
Insurance Median
$274
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: $1,145 (470%)
Insurance Median: $274 (112%)
Cash: $1,145 (470% of Medicare)
Ins. Median: $274 (112% 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.
Out-of-Pocket Cost Estimator
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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 | $123 - $608 | 50% |
| Bluechoice [810] | $146 - $821 | 60% |
| Tricare | $239 | 98% |
| Champva [3049] | $243 | 100% |
| Cigna | $243 - $1,215 | 100% |
| Covid19 Hrsa Uninsured Testing & Treatment Fund [904] | $243 | 100% |
| Deseret Mutual Ins Co [3066] | $243 | 100% |
| Generic Skilled Nursing [3196] | $243 | 100% |
| Hospice Contracted [1500] | $243 | 100% |
| Hospice Non Contracted [3190] | $243 | 100% |
| Medicare (plans) | $243 - $648 | 100% |
| Triwest Healthcare Alliance Vcp [902] | $243 | 100% |
| Va Community Care Network-Vaccn [903] | $243 | 100% |
| Veterans Administration [3194] | $243 | 100% |
| Humana | $248 - $694 | 102% |
| UnitedHealthcare | $251 - $1,157 | 103% |
| Aetna | $255 - $1,391 | 105% |
| Healthy Conn Prime-Wellcare Prime By Atc [5310] | $255 | 105% |
| Healthy Conn Prime-First Choice Vip Care [5300] | $258 | 106% |
| Healthy Conn Prime-Molina Healthcare [5330] | $267 | 110% |
| Medicaid / KanCare | $271 - $681 | 111% |
| Sc Dept Of Corrections [2998] | $274 | 112% |
| Scdc-Sc Dept Of Corrections [7232] | $274 | 112% |
| Workers Comp [600] | $340 | 139% |
| Prisma Health Seniorcare Pace - Midlands [5400] | $409 | 168% |
| Prisma Health Seniorcare Pace-Upstate [5200] | $409 | 168% |
| Ambetter / Centene | $447 | 183% |
| Bob Jones Univ-Pai [821] | $601 | 247% |
| Planned Administrators [820] | $608 | 249% |
| Promise Health Plan Contracted [2401] | $616 - $1,057 | 253% |
| First Choice Benefits Mgmt [3074] | $648 | 266% |
| Orangeburg Senior Helping Center Pace [5401] | $704 | 289% |
| Meritain Health Contracted [2200] | $1,127 - $1,391 | 462% |
| Golden Rule Insurance Company [2991] | $1,157 | 475% |
| Oxford Health Plans [2992] | $1,157 | 475% |
| Zzumr-Salt Lake City Ut [3169] | $1,157 | 475% |
| Evernorth Behavioral Contracted [2982] | $1,215 | 498% |
| Mvp Health Care [3037] | $1,215 | 498% |
| Preferred Administrators Contracted [2839] | $1,233 | 506% |
| Medcost [2940] | $1,303 - $1,462 | 535% |
| Atlantic Packaging Contracted [4833] | $1,321 | 542% |
| Aps Healthcare System [2981] | $1,409 | 578% |
| Multiplan/Phcs Contracted [2950] | $1,567 | 643% |
| Vsp Vision Care [2986] | $1,585 | 650% |
| First Health Contracted [2952] | $1,638 | 672% |
| Furman Int/Allen University Student [2951] | $1,638 | 672% |
| Quiktrip-First Health [3067] | $1,638 | 672% |