CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Baldwin Health

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $816
  • Cash Discount Price: $1,089
  • vs. Medicare Baseline: 3.35x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Baldwin Health is $816. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,089. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.35x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$1,089

Average discount available for prompt cash payment at this facility.

Insurance Median
$816

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: $1,089 (447%)
Insurance Median: $816 (335%)
Cash: $1,089 (447% of Medicare)
Ins. Median: $816 (335% 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 335% of the Medicare baseline (a markup of 235%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $95 39%
Veterans Eval Services $210 86%
Tricare $215 88%
Triwest $222 91%
Blue Cross Blue Shield $223 - $232 91%
Humana $223 91%
Medicare (plans) $223 91%
UnitedHealthcare $223 - $1,104 91%
Windsor Health Plan $223 91%
Community Hospice $226 93%
Hospice $226 93%
Mercy Medical Hospice $226 93%
Node Champva $226 93%
Node Va $226 93%
Cigna $227 - $854 93%
Node Devoted Health Mcr Adv $227 93%
Aetna $229 - $4,082 94%
Node Clover Health Mcr Adv $229 94%
Select Health $229 94%
Node Wellcare Mcr Adv $231 95%
Us Dol $283 116%
Ambetter / Centene $340 139%
First Choice $367 151%
Self Pay $816 - $1,361 335%
American Employee Alliance $1,814 744%
Multiplan $2,585 - $3,719 1060%
First Health $3,402 - $3,662 1396%
Alamed $3,470 1423%
Multiplan Inc $3,470 1423%
Coventry Work Comp Al $3,547 1455%
One Health $3,628 1488%
Pro America $3,628 1488%
Novanet $3,662 1502%
Alabama Wc $3,855 1581%
Gulf Health $3,855 1581%
Principal Ppo $3,855 1581%
Viva Health $3,855 1581%
National Health $4,082 1675%
Galaxy $4,127 1693%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals