CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Porter Hospital Inc

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $95
Cash Discount Price: $561
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Porter Hospital Inc is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $561. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.39x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$561

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $561 (230%)

Insurance Median: $95 (39%)

Cash: $561 (230% of Medicare)

Ins. Median: $95 (39% 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
UnitedHealthcare	$21 - $989	9%
Mvp	$26 - $931	11%
Fidelis Care	$27 - $423	11%
Humana	$29 - $230	12%
Aetna	$30 - $470	12%
Capital District Physicians' Health Plan	$30 - $833	12%
Martins Point	$30 - $470	12%
Veterans Affairs Community Care Network	$30 - $470	12%
Veterans Choice	$30 - $470	12%
Blue Cross Blue Shield	$35 - $779	14%
Cigna	$36 - $909	15%
Harvard Pilgrim	$36 - $799	15%
Coventry	$39 - $879	16%
Wellpath	$68 - $549	28%
Medical Corporation	$117 - $949	48%
Multiplan	$117 - $949	48%

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 $561.
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 Porter Hospital Inc 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.