CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Witham Health Services

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,084
Cash Discount Price: $1,971
vs. Medicare Baseline: 8.55x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Witham Health Services is $2,084. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,971. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.55x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$1,971

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,084

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: $1,971 (809%)

Insurance Median: $2,084 (855%)

Cash: $1,971 (809% of Medicare)

Ins. Median: $2,084 (855% 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 855% of the Medicare baseline (a markup of 755%). 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
Blue Cross Blue Shield	$190 - $2,382	78%
Mdwise Health In-All Plans	$252	103%
Caresource Mcr Adv	$257	105%
Aetna	$260 - $2,239	107%
Caresource Indiana Marketplace-All Other Plans	$480	197%
UnitedHealthcare	$2,033 - $2,360	834%
Phcs/Multiplan-All Plans	$2,372 - $2,753	973%
Sagamore-All Plans	$2,398 - $2,783	984%
Humana	$2,424 - $2,813	994%
Beech Street-All Plans	$2,450 - $2,844	1005%
Encore-All Plans	$2,476 - $2,874	1016%
Mhs Comml Exch-All Plans	$6,515 - $7,563	2673%

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 $1,971.
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 Witham Health Services 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.