CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Sycamore Shoals Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $227
  • Cash Discount Price: $344
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Sycamore Shoals Hospital is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $344. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.93x the Medicare baseline. Located in 1501 West Elk Avenue, Elizabethton, TN.
Cash / Self-Pay
$344

Average discount available for prompt cash payment at this facility.

Insurance Median
$227

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: $344 (141%)
Insurance Median: $227 (93%)
Cash: $344 (141% of Medicare)
Ins. Median: $227 (93% 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

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $124 - $649 51%
UnitedHealthcare $137 - $1,694 56%
Amerigroup $215 - $216 88%
Aetna $216 - $1,464 89%
Humana $216 89%
Managed Medicaire $216 89%
Medicare (plans) $216 89%
Sentara Health $216 - $638 89%
United Mine Workers Of America $216 89%
Molina Healthcare $225 - $236 92%
Cigna $227 - $1,065 93%
Devoted Health Plan $227 93%
Nhc Advantage $227 93%
Optima Health $227 93%
Wellcare $229 - $2,295 94%
Ambetter / Centene $472 194%
Medcost $803 329%
First Health Coventry $1,721 706%
Seven Corners, Inc. $2,295 941%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1501 West Elk Avenue, Elizabethton, TN 37643
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals