CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Reston Hospital Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,072
Cash Discount Price: $3,448
vs. Medicare Baseline: 4.40x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Reston Hospital Center is $1,072. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,448. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.40x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$3,448

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,072

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: $3,448 (1414%)

Insurance Median: $1,072 (440%)

Cash: $3,448 (1414% of Medicare)

Ins. Median: $1,072 (440% 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 440% of the Medicare baseline (a markup of 340%). 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
Lifeworks	$655	269%
Universal Healthcare Group	$759	311%
Bright Health	$867	356%
Cigna	$889 - $933	365%
United	$965 - $1,552	396%
Carefirst	$1,005	412%
Aetna	$1,138	467%
Greenvbrier Sporting Club	$2,069	849%
Virginia Health Network	$2,448	1004%
Corvel	$2,483	1019%
Occunet Workers Comp	$2,758	1131%
4Most Health Network	$3,103	1273%

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 $3,448.
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 Reston Hospital 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.