CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mc Donough District Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $275
Cash Discount Price: $661
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mc Donough District Hospital is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $661. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.13x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.

Cash / Self-Pay

$661

Average discount available for prompt cash payment at this facility.

Insurance Median

$275

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: $661 (271%)

Insurance Median: $275 (113%)

Cash: $661 (271% of Medicare)

Ins. Median: $275 (113% 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
Health Alliance	$19 - $1,674	8%
Hfn	$30 - $1,693	12%
UnitedHealthcare	$30 - $1,693	12%
Aetna	$31 - $1,881	13%
Humana	$31 - $1,693	13%
Medicaid / KanCare	$31 - $1,881	13%
Medicare (plans)	$31 - $270	13%
Meridian	$31 - $270	13%
Molina	$31 - $1,881	13%
Mutual Medical	$31 - $1,881	13%
Veteran Affairs	$31 - $270	13%
Blue Cross Blue Shield	$211 - $1,881	87%
Tricare	$252	103%
Springfield Health	$265 - $1,542	109%
Consociate	$275 - $1,599	113%
Trilogy	$275 - $1,599	113%
Blue Choice	$291 - $1,693	119%
Current Health	$291 - $1,693	119%
Healthlink	$291 - $1,768	119%
Preferred Plan	$307 - $1,787	126%

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 $661.
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 Mc Donough District 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.