CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Baylor Scott & White Medical Center Plano

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,005
Cash Discount Price: $1,112
vs. Medicare Baseline: 4.12x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Baylor Scott & White Medical Center Plano is $1,005. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,112. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.12x the Medicare baseline. Located in 4700 Alliance Boulevard, Plano, TX.

Cash / Self-Pay

$1,112

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,005

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: $1,112 (456%)

Insurance Median: $1,005 (412%)

Cash: $1,112 (456% of Medicare)

Ins. Median: $1,005 (412% 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 412% of the Medicare baseline (a markup of 312%). 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
Superior Health Plan	$189 - $235	78%
Baylor Scott & White Health Plan	$213 - $1,075	87%
Aetna	$224 - $1,087	92%
Humana	$224 - $1,297	92%
Triwest	$224	92%
American Health Plan	$235	96%
Blue Cross Blue Shield	$235 - $1,005	96%
Corvel	$235	96%
Healthspring	$235	96%
Prime Health Services	$235	96%
Procare Advantage	$235	96%
UnitedHealthcare	$258 - $1,297	106%
Ambetter / Centene	$464	190%
Cigna	$914 - $1,075	375%
Employers Health Network	$1,019	418%
Quiktrip	$1,019	418%
University Of Mary Hardin-Baylor	$1,075	441%
Independent Medical System	$1,112	456%
Imagine Health	$1,161	476%
Curative	$1,205	494%
First Health	$1,297	532%
Healthsmart	$1,297 - $1,390	532%
Private Health Care System	$1,390	570%

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 $1,112.
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 Baylor Scott & White Medical Center Plano 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.