CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Luke's Patients Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $363
Cash Discount Price: $1,797
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Luke's Patients Medical Center is $363. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,797. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.49x the Medicare baseline. Located in 4600 East Sam Houston Parkway South, Pasadena, TX.

Cash / Self-Pay

$1,797

Average discount available for prompt cash payment at this facility.

Insurance Median

$363

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: $1,797 (737%)

Insurance Median: $363 (149%)

Cash: $1,797 (737% of Medicare)

Ins. Median: $363 (149% 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.

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
Chc	$179	73%
Tchp	$179	73%
Wellpoint	$189 - $363	78%
United	$193 - $589	79%
Blue Cross Blue Shield	$239 - $520	98%
Cigna	$242 - $3,594	99%
Humana	$242	99%
Kelsey	$242	99%
Aetna	$247	101%
Amerivantage	$249	102%
Devoted	$259	106%
Scanhealth	$259	106%
Ambetter / Centene	$363	149%
Community Health Choice	$363	149%
Bright Health	$385	158%
Coventry	$3,337	1369%
First Health	$3,337	1369%
Healthsmart	$3,594	1474%
Multiplan	$3,850	1579%

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 $1,797.
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 St Luke's Patients 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.