CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Henry County Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $259
Cash Discount Price: $946
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Henry County Memorial Hospital is $259. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $946. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.06x the Medicare baseline. Located in 1000 N 16Th St, New Castle, IN.

Cash / Self-Pay

$946

Average discount available for prompt cash payment at this facility.

Insurance Median

$259

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: $946 (388%)

Insurance Median: $259 (106%)

Cash: $946 (388% of Medicare)

Ins. Median: $259 (106% 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
UnitedHealthcare	$27 - $1,309	11%
Blue Cross Blue Shield	$30 - $1,231	12%
Caresource Hip	$30 - $256	12%
Humana	$30 - $1,415	12%
Aetna	$31 - $1,367	13%
Caresource Mcr Adv	$31 - $261	13%
Encore Workers Comp-All Plans	$35 - $1,528	14%
Cigna	$37 - $1,093	15%
Caresource Marketplace-All Other Plans	$41 - $486	17%
Caresource Just4Me	$46 - $640	19%
Caresource Mcaid	$171 - $195	70%
Health Alliance-All Plans	$201 - $1,367	82%
Workers Comp - All Plans	$212 - $1,447	87%

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 $946.
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 Henry County 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.