CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Franciscan Health Michigan City

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,500
Cash Discount Price: $516
vs. Medicare Baseline: 6.15x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Franciscan Health Michigan City is $1,500. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $516. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.15x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$516

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,500

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: $516 (212%)

Insurance Median: $1,500 (615%)

Cash: $516 (212% of Medicare)

Ins. Median: $1,500 (615% 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 615% of the Medicare baseline (a markup of 515%). 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
Medicare (plans)	$252 - $256	103%
Blue Cross Blue Shield	$386 - $1,242	158%
Unicare [1150]	$386 - $871	158%
Workers Comp [1172]	$505 - $511	207%
Mdwise [1175]	$740	304%
Medicaid / KanCare	$740 - $887	304%
Managed Health Services [1302]	$762	313%
Aetna	$1,018 - $1,862	418%
Managed Care [2000]	$1,018 - $2,235	418%
Commercial [2001]	$1,487 - $2,483	610%
United Medical Resources [1158]	$1,487	610%
United Medical Resources [1301]	$1,487 - $1,654	610%
UnitedHealthcare	$1,487 - $1,654	610%
Cigna	$1,500 - $1,738	615%
Great West Insurance [1055]	$1,500	615%

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 $516.
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 Franciscan Health Michigan City 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.