CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $237
Cash Discount Price: $906
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Ascension Providence Hospital, Southfield and Novi is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $906. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.97x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$906

Average discount available for prompt cash payment at this facility.

Insurance Median

$237

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: $906 (372%)

Insurance Median: $237 (97%)

Cash: $906 (372% of Medicare)

Ins. Median: $237 (97% 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
Medicaid / KanCare	$81 - $237	33%
Molina Health	$81 - $137	33%
Blue Caid Michigan	$137	56%
Harbor Health Mcd	$137	56%
Total Health Care	$137	56%
UnitedHealthcare	$137	56%
Amerihealth Vip Care Mcr	$204 - $234	84%
Bc Metro Detroit Epo	$215 - $841	88%
Bc Metro Detroit Hmo	$215 - $841	88%
Bcn Local Network Southeast	$215 - $841	88%
Blue Care Network	$215 - $841	88%
Blue Cross Blue Shield	$215 - $841	88%
Aetna	$237 - $238	97%
Auto Insurance	$237	97%
Jvhl - Mcr Replacement	$237	97%
Mcr Replacement	$237	97%
Veterans Choice	$237	97%
Humana	$239	98%
Meridian Wellcare	$249	102%
Molina Advantage	$249	102%
Hap Alliance Health	$251	103%
Hap Hmo Pos	$251	103%
Ambetter / Centene	$296	121%
Hap Preferred	$296	121%
Molina Marketplace	$296	121%
Smart Health	$327	134%

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 $906.
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 Ascension Providence Hospital, Southfield and Novi 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.