CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Saint Thomas Highlands Hospital

Billing Code: 93970 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$243

about 1.0× the $244 Medicare rate · typically $231–$243

modeled estimate · not a bill or quote

What this hospital charges insurers

$228

About the fair price

about $15 under the fair price · 0.9× Medicare

Medicare pays $244 Fair price $243 This hospital $228 Cash price $547 Hospital's list price $1,825

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $151 Priciest $228

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

A fair price for a Ultrasound, leg veins (duplex) is about $243 (about 1.0× the $244 Medicare rate). Saint Thomas Highlands Hospital charges insurers about $228, or about $547 in cash — about the fair price. Located in Sparta, TN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$228	94%
Blue Cross Blue Shieldmajor	$108 - $316	44%
Aetnamajor	$233 - $1,078	96%
Cignamajor	$370 - $433	152%
Humanamajor	$228	94%
Ambetter (Centene)	$297	122%
Amerigroup	$228	94%
Cigna HealthSpring	$228	94%
Oscar Health	$319	131%
+ 6 smaller / regional plans	$76 - $319

Government programs also on file: Medicare.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 547), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 93970.

Insurance Before you use insurance

Call your insurance company to confirm Saint Thomas Highlands Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 93970.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at Saint Thomas Highlands Hospital

Compare: Ultrasound, leg veins (duplex) at other TN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.