CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,500
Cash Discount Price: $2,234
vs. Medicare Baseline: 10.26x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Memorial Hospital is $2,500. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,234. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.26x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.

Cash / Self-Pay

$2,234

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,500

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: $2,234 (916%)

Insurance Median: $2,500 (1026%)

Cash: $2,234 (916% of Medicare)

Ins. Median: $2,500 (1026% 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 1026% of the Medicare baseline (a markup of 926%). 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	$558 - $2,793	229%
Consociate	$558 - $2,793	229%
Humana	$700 - $2,793	287%
Blue Cross Blue Shield	$782 - $2,793	321%
Cigna	$782 - $2,793	321%
Health Alliance	$782 - $2,793	321%
Meridian	$782 - $2,793	321%
Molina	$782 - $2,793	321%
UnitedHealthcare	$782 - $2,793	321%
First Health Network	$1,374 - $2,486	564%
Healthlink	$2,374 - $2,793	974%
Private Healthcare Systems	$2,374	974%
Integrated Health Plan	$2,458	1008%
Health Dynamics	$2,514	1031%
Health Payors Org	$2,514	1031%
Iowa Health Solutions	$2,514	1031%
Multiplan	$2,514	1031%
Preferred Plan Inc	$2,514	1031%
Three Rivers Provider Network	$2,514	1031%
Health First Network	$2,542	1043%
Pponext	$2,542	1043%
Corvel	$2,653	1088%

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 $2,234.
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 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.