CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Fayette Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $365
Cash Discount Price: $509
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Fayette Medical Center is $365. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $509. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.50x the Medicare baseline. Located in 1653 Temple Avenue North, Fayette, AL.

Cash / Self-Pay

$509

Average discount available for prompt cash payment at this facility.

Insurance Median

$365

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: $509 (209%)

Insurance Median: $365 (150%)

Cash: $509 (209% of Medicare)

Ins. Median: $365 (150% 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
Medicaid / KanCare	$95	39%
Blue Cross Blue Shield	$215	88%
Humana	$215 - $610	88%
Medicare (plans)	$215	88%
Simpra	$215	88%
UnitedHealthcare	$215 - $1,017	88%
Aetna	$219 - $559	90%
Seven Corners	$365	150%
Al. Dept Of Mental Health	$509	209%
Cigna	$559	229%
Healthnet	$559	229%
Healthspring	$1,017	417%

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 $509.
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 Fayette 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.