CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Fayette County Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $332
Cash Discount Price: $1,043
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Fayette County Hospital is $332. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,043. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.36x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$1,043

Average discount available for prompt cash payment at this facility.

Insurance Median

$332

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: $1,043 (428%)

Insurance Median: $332 (136%)

Cash: $1,043 (428% of Medicare)

Ins. Median: $332 (136% 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
Aetna	$33 - $1,310	14%
Health Alliance Mcare	$33 - $608	14%
Healthlink Mcr Adv	$33 - $608	14%
Cigna	$38 - $1,424	16%
Coventry/Ghp-All Plans	$44 - $1,234	18%
Multiplan - All Plans	$60 - $1,614	25%
Health Alliance - All Other Plans	$65 - $1,569	27%
Blue Cross Blue Shield	$68 - $1,595	28%
UnitedHealthcare	$154 - $1,576	63%
Healthlink Hmo	$160 - $1,329	66%
Healthlink Ppo - All Other Plans	$160 - $1,519	66%
Illinicare - All Plans	$332	136%
Medicaid / KanCare	$332	136%
Meridian-All Plans	$332	136%
Humana	$608	249%

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 $1,043.
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 Fayette County 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.