CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Woodlawn Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $387
Cash Discount Price: $1,280
vs. Medicare Baseline: 1.59x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Woodlawn Hospital is $387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,280. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.59x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$1,280

Average discount available for prompt cash payment at this facility.

Insurance Median

$387

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: $1,280 (525%)

Insurance Median: $387 (159%)

Cash: $1,280 (525% of Medicare)

Ins. Median: $387 (159% 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
Blue Cross Blue Shield	$190 - $1,368	78%
Caresource Mcaid Hww	$190	78%
Mdwise Excel Hhw & Hcc	$190	78%
Mhs Mcaid Hcc	$190	78%
Mhs Mcaid Hhw	$190	78%
UnitedHealthcare	$190 - $1,297	78%
Aetna	$376 - $1,622	154%
Caresource Mcaid Hip	$376	154%
Caresource Mcr Adv	$376	154%
Humana	$376 - $1,325	154%
Mdwise Mcaid Excel Hip	$376	154%
Mhs Exch Mrktplce-All Other Plans	$376	154%
Mhs Mcaid Hip	$376	154%
Mhs Mcr Adv	$383	157%
Caresource Exch - All Other Plans	$488	200%
Ambetter / Centene	$499	205%
Partners Direct Health-All Plans	$1,161	476%
Cigna	$1,222 - $1,451	501%
Parkview Health Plans-All Plans	$1,280	525%
Sagamore All Other Grps - All Other Plans	$1,434	588%
Encore Comm-All Plans	$1,451	595%
Phcs/Multiplan-All Plans	$1,588	651%
Community Health Alliance-All Plans	$1,622	665%

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 $1,280.
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 Woodlawn 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.