CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Texas Orthopedic Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $627
  • Cash Discount Price: $3,097
  • vs. Medicare Baseline: 2.57x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Texas Orthopedic Hospital is $627. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,097. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.57x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$3,097

Average discount available for prompt cash payment at this facility.

Insurance Median
$627

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: $3,097 (1270%)
Insurance Median: $627 (257%)
Cash: $3,097 (1270% of Medicare)
Ins. Median: $627 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Texas Health Network $185 76%
Superior Health Plan $186 76%
Amerigroup $189 78%
Community Health Choice Mcd $192 79%
United $196 - $1,393 80%
Aetna $207 - $1,062 85%
Molina Healthcare $208 85%
Humana $236 - $1,522 97%
Texas Athletic Network $300 - $600 123%
Blue Cross Blue Shield $383 - $1,084 157%
Cigna $458 - $728 188%
Texas Childrens Health Plans $514 - $734 211%
Oscar $604 248%
Texas Workforce Commission $743 305%
Healthcare Highways $790 324%
Evry Health $845 347%
Imagine Health $1,084 445%
Christus (Usfhp) $1,239 508%
Curative Administrators $1,239 508%
Healthsmart Preferred Care $1,332 - $2,632 546%
Averde Health $1,393 571%
Fidelis Securecare Of Tx $1,393 571%
Coventry National First Health $1,651 677%
Physicians Cooperative Of Texas $1,703 699%
Rockport Workers Comp $1,703 699%
Independent Medical System $1,858 762%
National Healthcare Solutions $1,858 762%
Southwest Medical $1,858 762%
Coastal Comp $2,013 826%
Multiplan $2,322 - $2,632 953%
International Health Insurance $2,477 1016%
Physicians, Inc $2,632 1080%
Affiliated Ppo $2,787 1143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals