CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Uva Health Culpeper Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $622
Cash Discount Price: $1,015
vs. Medicare Baseline: 2.55x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Uva Health Culpeper Medical Center is $622. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,015. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.55x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$1,015

Average discount available for prompt cash payment at this facility.

Insurance Median

$622

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: $1,015 (416%)

Insurance Median: $622 (255%)

Cash: $1,015 (416% of Medicare)

Ins. Median: $622 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Champva [50002]	$155 - $158	64%
Tricare	$155 - $158	64%
Blue Ridge Pace [10510]	$215	88%
Medicaid / KanCare	$215	88%
Aetna	$239 - $1,756	98%
Blue Cross Blue Shield	$239 - $715	98%
Cigna	$239 - $1,356	98%
HMO Part B [10099]	$239	98%
Humana	$239 - $252	98%
Medicare (plans)	$239 - $247	98%
UnitedHealthcare	$239 - $1,435	98%
VA Ccn [99926]	$239 - $247	98%
VA Ccn [99927]	$239 - $247	98%
Veterans Administration [99910]	$247	101%
Carefirst [30007]	$558 - $697	229%
Geha [40009]	$622 - $1,160	255%
Sentara [40021]	$741 - $1,577	304%
Sentara Behavioral Health [40052]	$757 - $1,577	311%
Beacon Health Options [40012]	$998	409%
Commercial Contracted Hb Only [40056]	$1,048	430%
Commercial Generic [40000]	$1,048 - $1,397	430%
Commercial Contracted Tpa [40055]	$1,198 - $1,397	491%
Umwa [40037]	$1,397	573%
Healthsmart [40013]	$1,497	614%
Multiplan Generic [40035]	$1,543 - $1,697	633%
Vhn Generic [40040]	$1,543 - $1,697	633%
First Health Generic [40033]	$1,637	672%
Gateway Health Alliance [40034]	$1,697	696%
Onenet Workers Comp Generic [60010]	$1,748	717%
Kaiser Permenente [40014]	$1,827	749%

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 $1,015.
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 Uva Health Culpeper 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.