CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Medical Center Enterprise

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $222
  • Cash Discount Price: $1,215
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Medical Center Enterprise is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,215. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.91x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$1,215

Average discount available for prompt cash payment at this facility.

Insurance Median
$222

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: $1,215 (498%)
Insurance Median: $222 (91%)
Cash: $1,215 (498% of Medicare)
Ins. Median: $222 (91% 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.

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
Al Maternity Waiver Program $72 30%
Medicaid / KanCare $95 - $104 39%
Tricare $195 80%
Blue Cross Blue Shield $202 - $222 83%
Humana $202 83%
Medicare (plans) $202 83%
UnitedHealthcare $202 - $671 83%
Select Health $204 84%
Covenant Hospice $206 85%
Dayspring Hospice $206 85%
Healthspring $206 85%
Node Champva $206 85%
Node Devoted Health Mcr Adv $206 85%
Node Hospice Non Par $206 85%
Node Va $206 85%
Southerncare Hospice $206 85%
Aetna $208 - $4,361 85%
Node Clover Mcr Adv $208 85%
Node Wellcare Mcr Adv $210 86%
Veterans Eval Services $210 86%
Eon Health $212 87%
Wiregrass Hospice $218 89%
Node Us Dept Of Labor $257 105%
Ambetter / Centene $308 126%
Cigna $346 - $2,183 142%
Occunet $360 148%
Self Pay $561 - $1,869 230%
American Employee Alliance $2,492 1022%
Alamed $3,738 1533%
Affordable Health $4,361 1789%
Health Choice $4,361 1789%
Novanet Ppo $4,361 1789%
Coventry Work Comp Al $4,585 1881%
Multiplan $4,610 - $4,921 1891%
Wc Dept Ind Relations $4,984 2045%
Corvel $5,295 2172%
Galaxy Health $5,607 2300%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals