CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: T J Samson Community Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $172
Cash Discount Price: $488
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at T J Samson Community Hospital is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $488. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.71x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$488

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

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: $488 (200%)

Insurance Median: $172 (71%)

Cash: $488 (200% of Medicare)

Ins. Median: $172 (71% 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	$31 - $1,207	13%
Center Care Select - All Plans	$31 - $1,207	13%
Signature Health - All Plans	$31 - $245	13%
Wellcare Mcr Adv - All Other Plans	$31 - $243	13%
Molina Mcr Adv	$32 - $247	13%
Devoted Mcr Adv - All Plans	$33 - $255	14%
Humana	$33 - $243	14%
Caresource - All Plans	$40 - $364	16%
Molina Marketplace - All Other Plans	$40 - $364	16%
Aetna	$82 - $172	34%
Wellcare Mcaid	$82 - $238	34%
Molina Mcaid	$84 - $177	34%
UnitedHealthcare	$1,103	452%
Phcs/Multiplan - All Plans	$1,335	548%
First Health - All Plans	$1,349	553%

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 $488.
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 T J Samson Community 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.