CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Franklin General Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $530
Cash Discount Price: $1,130
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Franklin General Hospital is $530. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,130. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.17x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$1,130

Average discount available for prompt cash payment at this facility.

Insurance Median

$530

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: $1,130 (464%)

Insurance Median: $530 (217%)

Cash: $1,130 (464% of Medicare)

Ins. Median: $530 (217% 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 217% of the Medicare baseline (a markup of 117%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Wellmark Hmo	$303	124%
Wellmark Ppo - All Other Plans	$333	137%
Medical Associates Mcare	$502	206%
Mount Carmel Hp-All Plans	$502	206%
Tricare	$502	206%
UnitedHealthcare	$502 - $1,043	206%
Amerigroup Mcare	$507	208%
Wellmark Mcr Adv	$507	208%
Molina Mcare	$522	214%
Ambetter / Centene	$525 - $803	215%
American Hp Iowa - All Plans	$527	216%
Amerigroup Mcaid - All Other Plans	$530	217%
Molina Mcaid - All Other Plans	$533	219%
Centivo - All Plans	$753	309%
Medical Ass Hosp Employer Group	$753	309%
Oscar - All Plans	$753	309%
Midlands Choice-All Plans	$878	360%
Medical Associates Hp-All Other Plans	$1,067	438%
Preferred Health Choices-All Plans	$1,067	438%
Splashlight Llc-All Plans	$1,067	438%
Aetna	$1,167 - $1,192	479%
Multiplan-All Plans	$1,192	489%

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 $1,130.
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 Franklin General 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.