CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Prosser Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $71
Cash Discount Price: $474
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Prosser Memorial Hospital is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $474. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.29x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$474

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $474 (194%)

Insurance Median: $71 (29%)

Cash: $474 (194% of Medicare)

Ins. Median: $71 (29% 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
Amerigroup	$19 - $662	8%
Molina	$19 - $625	8%
Community Health Plan Of Washington	$36 - $625	15%
Health Alliance Northwest	$36 - $386	15%
Humana	$36 - $1,312	15%
Kaiser Permanente	$36 - $1,404	15%
UnitedHealthcare	$36 - $1,234	15%
Wellcare	$36 - $386	15%
Cigna	$41 - $1,265	17%
Aetna	$42 - $1,312	17%
Premera	$45 - $1,234	18%
Asuris	$49 - $1,389	20%
Health Management Adminstrators	$49 - $1,389	20%
Regence	$49 - $1,389	20%
Ambetter / Centene	$64 - $1,188	26%
Multiplan	$152 - $1,389	62%
Coordinated Care	$329 - $625	135%
First Choice	$1,312	538%

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 $474.
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 Prosser Memorial Hospital 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.