CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Joseph Health System, LLC

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $368
  • Cash Discount Price: $220
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Joseph Health System, LLC is $368. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $220. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.51x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$220

Average discount available for prompt cash payment at this facility.

Insurance Median
$368

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: $220 (90%)
Insurance Median: $368 (151%)
Cash: $220 (90% of Medicare)
Ins. Median: $368 (151% 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.

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
Amish Aid $22 - $587 9%
Self Pay $22 - $1,345 9%
Php $23 - $977 9%
Lutheran Preferred $26 - $1,467 11%
Php Freedom Network $28 - $766 11%
Cigna $29 - $2,445 12%
Blue Cross Blue Shield $33 - $1,037 14%
Lutheran Network $40 - $1,345 16%
Three Rivers $40 - $1,100 16%
Aetna $41 - $1,663 17%
Encore Ppo $46 - $2,200 19%
Sagamore $47 - $1,323 19%
Multiplan $62 - $1,907 25%
First Health $68 - $1,834 28%
Prime Health Services $68 - $1,834 28%
Align Network $72 - $1,956 30%
Frontpath Health Coalition $72 - $1,956 30%
Advantage Health Solutions $75 - $2,029 31%
Allied Benefit Systems $81 - $2,200 33%
Medical Mutual Of Ohio $90 - $2,445 37%
Parkview Healthplan Services $90 - $2,445 37%
Value Options $90 - $2,445 37%
Veterans Eval Services $90 - $222 37%
UnitedHealthcare $224 - $1,218 92%
Tricare $240 98%
Humana $248 - $740 102%
Managed Health Services $248 - $740 102%
Medicare (plans) $248 102%
Department Of Veterans Affairs $252 103%
Node Hospice Non Par Agree $252 103%
Node Va $252 103%
Node Devoted Health Mcr Adv $253 104%
In Dept Of Correction $263 108%
Node Pphp Mcr Adv $265 109%
Us Department Of Labor $316 130%
Lutheran Advanced Network $379 155%
Encore Work Comp In $454 186%
Work Comp $505 207%
Encore Kba Epo $606 249%
Caresource $740 304%
Medicaid / KanCare $740 304%
Encore Kba Ppo $757 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals