CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Valley Regional Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,302
Cash Discount Price: $4,105
vs. Medicare Baseline: 5.34x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Valley Regional Medical Center is $1,302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,105. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.34x the Medicare baseline. Located in 100 A Alton Gloor, Brownsville, TX.

Cash / Self-Pay

$4,105

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,302

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: $4,105 (1684%)

Insurance Median: $1,302 (534%)

Cash: $4,105 (1684% of Medicare)

Ins. Median: $1,302 (534% 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 534% of the Medicare baseline (a markup of 434%). 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
Texas Health Network	$187	77%
Usa Mco	$189	78%
Driscoll Childrens Health Plan	$194	80%
United	$196 - $1,847	80%
Aetna	$207 - $1,741	85%
Molina Healthcare	$208	85%
Superior Health Plan	$287	118%
Texas Athletic Network	$300 - $600	123%
Blue Cross Blue Shield	$509 - $1,847	209%
Texas Workforce Commission	$985	404%
Healthcare Highways	$1,047	430%
Oscar	$1,117	458%
Cigna	$1,302 - $1,742	534%
Averde Health	$1,355	556%
Curative Administrators	$1,642	674%
Healthsmart Preferred Care	$1,765 - $3,489	724%
Humana	$2,298	943%
First Health	$2,360	968%
National Healthcare Solutions	$2,463	1010%
Southwest Medical	$2,463	1010%
Coastal Comp	$2,668	1094%
Total E&P Mexico	$2,668	1094%
Affiliated Healthcare	$2,791	1145%
Mcm Maxcare	$3,284	1347%
Pronet Ppo	$3,284	1347%
Usa Managed Care	$3,284	1347%
Beech Street	$3,694	1515%

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 $4,105.
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 Valley Regional 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.