CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $876
Cash Discount Price: $763
vs. Medicare Baseline: 3.59x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Thomas H Boyd Memorial Hospital is $876. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $763. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.59x the Medicare baseline. Located in 800 School St, Carrollton, IL.

Cash / Self-Pay

$763

Average discount available for prompt cash payment at this facility.

Insurance Median

$876

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: $763 (313%)

Insurance Median: $876 (359%)

Cash: $763 (313% of Medicare)

Ins. Median: $876 (359% 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 359% of the Medicare baseline (a markup of 259%). 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
Aetna	$89 - $1,300	37%
Blue Cross Blue Shield	$89 - $1,300	37%
Health Alliance Mcr Adv	$89 - $884	37%
UnitedHealthcare	$89 - $902	37%
Wellcare Mcr Adv-All Plans	$89 - $884	37%
Humana	$90 - $893	37%
Health Alliance-All Other Plans	$106 - $1,061	43%
Ambetter / Centene	$115 - $1,150	47%
Cigna	$124 - $1,236	51%
Multiplan-All Plans	$130 - $1,300	53%
Healthlink Hmo	$132 - $1,318	54%
Healthlink Il Only	$132 - $1,318	54%
Healthlink Ppo-All Other Plans	$150 - $1,491	62%
Hfn Zelis-All Plans	$158 - $1,578	65%
Meridian Hp Mcaid-All Plans	$876	359%
Molina Mcaid-All Plans	$876	359%

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 $763.
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 Thomas H Boyd Memorial 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.