CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Northwest Health - Starke

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $740
  • Cash Discount Price: $961
  • vs. Medicare Baseline: 3.04x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Northwest Health - Starke is $740. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $961. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.04x the Medicare baseline. Located in 102 E Culver Rd, Knox, IN.
Cash / Self-Pay
$961

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: $961 (394%)
Insurance Median: $740 (304%)
Cash: $961 (394% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
One Call $171 70%
UnitedHealthcare $239 - $1,659 98%
Tricare $240 98%
Node Champva $252 103%
Aetna $266 - $2,026 109%
Blue Cross Blue Shield $266 - $1,015 109%
Humana $266 - $740 109%
Medicare (plans) $266 109%
Managed Health Services $270 - $740 111%
Node Hospice Non Par Agree $270 111%
Node Va $270 111%
Node Devoted Health Mcr Adv $271 111%
In Dept Of Correction $281 115%
Node Pphp Mcr Adv $284 117%
Us Department Of Labor $338 139%
Encore $487 - $2,038 200%
Indiana Workers Comp $541 222%
Lutheran Network $541 - $2,062 222%
Caresource $569 - $740 233%
Lutheran $633 260%
Self Pay $633 - $1,289 260%
Encore Kba Epo $649 266%
Magnacare Ma $649 266%
Medicaid / KanCare $740 304%
Mhs $740 304%
Medpartners $785 322%
Encore Kba Ppo $811 333%
Physicians Health Plan $968 397%
Alpha Baking $1,054 432%
Php $1,410 578%
Multiplan Inc $1,874 - $2,108 769%
Cigna $1,944 797%
Coventry First Health $2,026 831%
Sagamore Health Network $2,062 846%
Community Health Alliance $2,108 865%
Ppom $2,202 903%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Culver Rd, Knox, IN 46534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals