CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Tristar Summit Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,034
Cash Discount Price: $3,706
vs. Medicare Baseline: 4.24x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Tristar Summit Medical Center is $1,034. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,706. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.24x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.

Cash / Self-Pay

$3,706

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,034

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: $3,706 (1520%)

Insurance Median: $1,034 (424%)

Cash: $3,706 (1520% of Medicare)

Ins. Median: $1,034 (424% 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 424% of the Medicare baseline (a markup of 324%). 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	$168 - $313	69%
Cigna	$486 - $2,965	199%
Bright Health	$630 - $890	258%
Oscar	$678	278%
Kentucky Labor Cabinet	$682	280%
Apex Health	$704	289%
Nhc Advantage, Inc.	$704	289%
Pruitt Health (Allyalign)	$704	289%
Ambetter / Centene	$826 - $860	339%
Humana	$927 - $2,409	380%
United	$1,034 - $1,668	424%
Aetna	$1,264 - $1,853	519%
Centurion	$1,527	626%
Bgfh Singlesource	$1,853 - $3,150	760%
Multiplan	$2,409	988%
Employers Health Network	$2,594	1064%
Odom'S Tn Pride Sausage	$2,780	1140%
Compsych	$2,965	1216%
Beech Street	$3,262	1338%
Prime Health	$3,262	1338%

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 $3,706.
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 Summit 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.