CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Tristar Horizon Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $757
  • Cash Discount Price: $3,088
  • vs. Medicare Baseline: 3.11x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Tristar Horizon Medical Center is $757. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,088. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.11x the Medicare baseline. Located in 111 Highway 70 East, Dickson, TN.
Cash / Self-Pay
$3,088

Average discount available for prompt cash payment at this facility.

Insurance Median
$757

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: $3,088 (1267%)
Insurance Median: $757 (311%)
Cash: $3,088 (1267% of Medicare)
Ins. Median: $757 (311% 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 311% of the Medicare baseline (a markup of 211%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $173 - $313 71%
Cigna $486 - $2,470 199%
Bright Health $525 - $741 215%
Oscar $565 232%
Kentucky Labor Cabinet $568 233%
Apex Health $587 241%
Nhc Advantage, Inc. $587 241%
Pruitt Health (Allyalign) $587 241%
Ambetter / Centene $689 - $716 283%
Humana $772 317%
United $948 - $1,390 389%
Aetna $1,264 - $1,544 519%
Centurion $1,272 522%
Bgfh Singlesource $1,544 - $2,625 633%
Employers Health Network $2,162 887%
Odom'S Tn Pride Sausage $2,316 950%
Multiplan $2,779 1140%
Beech Street $2,841 1165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 Highway 70 East, Dickson, TN 37055
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals