CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Tristar Skyline Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,401
Cash Discount Price: $4,298
vs. Medicare Baseline: 5.75x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Tristar Skyline Medical Center is $1,401. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,298. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.75x the Medicare baseline. Located in 3441 Dickerson Pike, Nashville, TN.

Cash / Self-Pay

$4,298

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,401

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: $4,298 (1763%)

Insurance Median: $1,401 (575%)

Cash: $4,298 (1763% of Medicare)

Ins. Median: $1,401 (575% 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 575% of the Medicare baseline (a markup of 475%). 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	$157 - $313	64%
Cigna	$486 - $1,468	199%
Bright Health	$696 - $1,081	286%
Oscar	$749 - $824	307%
Kentucky Labor Cabinet	$754 - $829	309%
Nhc Advantage, Inc.	$778 - $855	319%
Pruitt Health (Allyalign)	$778 - $855	319%
Ambetter / Centene	$913 - $1,045	375%
United	$1,011 - $2,026	415%
Humana	$1,023 - $2,926	420%
Aetna	$1,264 - $2,251	519%
Centurion	$1,686 - $1,855	692%
Bgfh Singlesource	$2,046 - $3,827	839%
Employers Health Network	$2,865 - $3,152	1175%
Mhnet	$3,070 - $3,377	1259%
Odom'S Tn Pride Sausage	$3,070 - $3,377	1259%
Multiplan	$3,356 - $3,692	1377%
Beech Street	$3,602 - $3,962	1478%
Prime Health	$3,602 - $3,962	1478%
Triwest Healthcare	$4,011 - $4,412	1645%

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 $4,298.
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 Tristar Skyline Medical Center 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.