CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $815
Cash Discount Price: $1,706
vs. Medicare Baseline: 3.34x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Sarah D Culbertson Memorial Hospital is $815. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,706. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.34x the Medicare baseline. Located in 238 South Congress Street, Rushville, IL.

Cash / Self-Pay

$1,706

Average discount available for prompt cash payment at this facility.

Insurance Median

$815

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: $1,706 (700%)

Insurance Median: $815 (334%)

Cash: $1,706 (700% of Medicare)

Ins. Median: $815 (334% 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 334% of the Medicare baseline (a markup of 234%). 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	$33 - $2,247	14%
Blue Cross Blue Shield	$33 - $2,447	14%
Molina Mmai-All Other Plans	$33 - $1,074	14%
UnitedHealthcare	$33 - $2,247	14%
Cigna	$39 - $1,845	16%
Multiplan/Phcs-All Plans	$98 - $2,247	40%
Humana	$144 - $1,074	59%
Health Dynamics-All Plans	$267 - $2,247	110%
Beech Street-All Plans	$301 - $2,247	123%
Encompass-All Plans	$301 - $2,247	123%
Hfn Epo	$301 - $2,247	123%
Hfn Ppo Ip/Op Only-All Other Plans	$301 - $2,247	123%
Preferred Medical Claims Solution-All Plans	$301 - $2,247	123%
Three Rivers Provider Network-All Plans	$301 - $2,247	123%
Wexford Ip/Op Only-All Plans	$301 - $2,247	123%
Healthsmart-All Plans	$317 - $2,372	130%
Healthlink-All Plans	$500 - $2,247	205%
Corvel-All Plans	$550	226%
Meridian Hp Mcaid-All Plans	$550	226%
Molina Healthcare Mcaid	$550	226%

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 $1,706.
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 Sarah D Culbertson 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.