CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Elkhart General Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $740
Cash Discount Price: $699
vs. Medicare Baseline: 3.04x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Elkhart General Hospital is $740. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $699. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.04x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$699

Average discount available for prompt cash payment at this facility.

Insurance Median

$740

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: $699 (287%)

Insurance Median: $740 (304%)

Cash: $699 (287% of Medicare)

Ins. Median: $740 (304% 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 304% of the Medicare baseline (a markup of 204%). 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
Mclaren (Mi	$136	56%
UnitedHealthcare	$136 - $740	56%
Devoted Healthcare	$215 - $266	88%
Blue Cross Blue Shield	$225 - $755	92%
Aetna	$253 - $728	104%
Humana	$253 - $752	104%
Pace	$253	104%
Plain Church	$380 - $860	156%
Caresource	$405 - $1,398	166%
Mhs	$456 - $1,398	187%
Cha	$645 - $838	265%
Immergrun	$645 - $860	265%
Php	$699 - $752	287%
Mdwise	$740 - $1,398	304%
Cigna	$774 - $817	318%
Multiplan	$774	318%
Signature	$785	322%
Encore	$796	327%
Heartland	$1,075	441%

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 $699.
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 Elkhart General 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.