CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Hammond Henry Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,201
Cash Discount Price: $1,441
vs. Medicare Baseline: 4.93x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Hammond Henry Hospital is $1,201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,441. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.93x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$1,441

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,201

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: $1,441 (591%)

Insurance Median: $1,201 (493%)

Cash: $1,441 (591% of Medicare)

Ins. Median: $1,201 (493% 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 493% of the Medicare baseline (a markup of 393%). 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	$402 - $1,201	165%
Blue Cross Blue Shield	$402 - $961	165%
Meridian Health Plan-All Plans	$402	165%
Tricare	$418	171%
Health Alliance Mcare Adv	$464	190%
UnitedHealthcare	$464 - $1,183	190%
Humana	$469 - $1,441	192%
Wellmark Of Ia-All Plans	$800	328%
Springfield Armory-All Plans	$1,041	427%
Ambetter / Centene	$1,121	460%
Health Alliance-All Other Plans	$1,201	493%
Multiplan Integrated Hp	$1,201	493%
Cigna	$1,233	506%
Multiplan Pponext	$1,281	525%
Osf Direct Access Network-All Plans	$1,281	525%
Quad City Community Hc-All Plans	$1,281	525%
Multiplan-All Other Plans	$1,361	558%
Corvel-All Plans	$1,441	591%
Healthsmart Adult-All Other Plans	$1,441	591%
Healthsmart Pediatric	$1,441	591%
Hfn-All Plans	$1,441	591%
Multiplan Beech Street	$1,441	591%
Multiplan Phcs Adult	$1,441	591%
Multiplan Phcs Pediatric	$1,441	591%
Usa Mco-All Plans	$1,441	591%

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 $1,441.
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 Hammond Henry 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.