CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Baylor Scott & White Medical Center Pflugerville

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $720
Cash Discount Price: $1,009
vs. Medicare Baseline: 2.95x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Baylor Scott & White Medical Center Pflugerville is $720. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,009. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.95x the Medicare baseline. Located in 2600 East Pflugerville Parkway, Pflugerville, TX.

Cash / Self-Pay

$1,009

Average discount available for prompt cash payment at this facility.

Insurance Median

$720

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: $1,009 (414%)

Insurance Median: $720 (295%)

Cash: $1,009 (414% of Medicare)

Ins. Median: $720 (295% 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 295% of the Medicare baseline (a markup of 195%). 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 - $219	78%
Baylor Scott & White Health Plan	$208 - $720	85%
Humana	$219 - $1,178	90%
Triwest	$219	90%
American Health Plan	$230	94%
Corvel	$230	94%
Healthspring	$230	94%
Prime Health Services	$230	94%
Procare Advantage	$230	94%
UnitedHealthcare	$252 - $1,163	103%
Sedgwick	$328	135%
Blue Cross Blue Shield	$465 - $566	191%
Cigna	$799 - $932	328%
Midcoast	$925	379%
Quiktrip	$925	379%
University Of Mary Hardin-Baylor	$976	400%
Independent Medical System	$1,009	414%
Aetna	$1,087	446%
Curative	$1,094	449%
First Health	$1,178	483%
Healthsmart	$1,178 - $1,262	483%
Private Health Care System	$1,262	518%
Three Rivers	$1,514	621%

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 $1,009.
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 Pflugerville 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.