CMS Price Transparency Data
Ultrasound, leg veins (duplex)
Facility: Trinity Health Oakland Hospital
Billing Code: 93970 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93970
- Insurance Median: $1,233
- Cash Discount Price: $1,178
- vs. Medicare Baseline: 5.06x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Trinity Health Oakland Hospital is $1,233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,178. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.06x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$1,178
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,233
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: $1,178 (483%)
Insurance Median: $1,233 (506%)
Cash: $1,178 (483% of Medicare)
Ins. Median: $1,233 (506% 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 506% of the Medicare baseline (a markup of 406%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 |
|---|---|---|
| Medicaid / KanCare | $131 - $133 | 54% |
| Blue Cross Blue Shield | $133 - $551 | 55% |
| Aetna | $233 - $1,135 | 96% |
| Blue Care Network Advantage | $233 | 96% |
| Medicare (plans) | $233 - $238 | 96% |
| Align Senior Care | $238 | 98% |
| Hospice Advantage | $238 | 98% |
| UnitedHealthcare | $245 - $1,360 | 101% |
| Cca - Zing Health | $252 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $268 | 110% |
| Molina Marketplace | $309 | 127% |
| Priority Health | $353 - $392 | 145% |
| Health Cost Solutions | $368 | 151% |
| Vitalcore | $368 | 151% |
| Wellpath | $368 | 151% |
| U Of M Health Plan | $407 | 167% |
| Asr Health Benefits | $545 | 224% |
| Caresource | $545 | 224% |
| Hap | $545 - $1,320 | 224% |
| Varipro | $545 | 224% |
| Employee Benefit Logistic | $549 | 225% |
| Wc Accident Fund | $550 | 226% |
| Wc Advantage | $550 | 226% |
| Wc Aig | $550 | 226% |
| Wc Allied | $550 | 226% |
| Wc Amerisure | $550 | 226% |
| Wc Amtrust | $550 | 226% |
| Wc Asu Risk Mgt | $550 | 226% |
| Wc Berkley Admin | $550 | 226% |
| Wc Broadspire | $550 | 226% |
| Wc Bunch & Associates | $550 | 226% |
| Wc Ccmsi | $550 | 226% |
| Wc Emc Insurance Company | $550 | 226% |
| Wc Esis | $550 | 226% |
| Wc Fcci | $550 | 226% |
| Wc Federated | $550 | 226% |
| Wc Gallagher Bassett | $550 | 226% |
| Wc Genex Care For Ohio | $550 | 226% |
| Wc Guard Insurance Company | $550 | 226% |
| Wc Hartford | $550 | 226% |
| Wc Liberty Mutual | $550 | 226% |
| Wc Meijers | $550 | 226% |
| Wc Michigan | $550 | 226% |
| Wc Mitchell Frankenmuth | $550 | 226% |
| Wc Pma | $550 | 226% |
| Wc Sedgwick | $550 | 226% |
| Wc Sentry | $550 | 226% |
| Wc Travelers | $550 | 226% |
| Wc Tristar | $550 | 226% |
| Wc Walmart | $550 | 226% |
| Wc Zurich | $550 | 226% |
| Bcn Domestic | $551 | 226% |
| Blue Benefit Administrators Of Massachusetts | $551 | 226% |
| Blue Care Network | $551 | 226% |
| Blue Distinction Transplant | $551 | 226% |
| Blue Shield - Ca | $551 | 226% |
| Blue Shield - Id (Regence) | $551 | 226% |
| Blue Shield - Ny Highmark Northeastern | $551 | 226% |
| Blue Shield - Ny Highmark Western | $551 | 226% |
| Blue Shield - Pa (Highmark) | $551 | 226% |
| Blue Shield - Wa (Regence) | $551 | 226% |
| Health Choices | $551 - $1,331 | 226% |
| Kaiser Domestic | $551 | 226% |
| Acs Benefit Services | $798 | 327% |
| Allied Benefit Systems | $798 | 327% |
| Claimchoice Adminstrators | $798 | 327% |
| Consociate | $798 | 327% |
| Cypress Benefit Administrators | $798 | 327% |
| Forest County Potawatomi | $798 | 327% |
| Health Smart | $798 | 327% |
| Healthgram | $798 | 327% |
| Healthscope | $798 | 327% |
| Secureone Preferred United Plans | $798 | 327% |
| Sisco Benefits | $798 | 327% |
| The Health Plan | $798 | 327% |
| Trustmark Small Business Benefits | $798 | 327% |
| Unified Group Services | $798 | 327% |
| Webtpa | $798 | 327% |
| Mclaren Health | $872 - $951 | 358% |
| Carelon Behavioral Health | $906 | 372% |
| Magellan Behavioral Health | $1,088 | 446% |
| Geha | $1,135 - $1,360 | 466% |
| Medical Mutual | $1,135 | 466% |
| Meritain | $1,135 | 466% |
| 1199 National Benefit Fund | $1,233 | 506% |
| Allied National Global Care | $1,233 | 506% |
| Asrm - Reliance Standard Life Insurance | $1,233 | 506% |
| Christian Care Ministry | $1,233 | 506% |
| Dean Health | $1,233 | 506% |
| Fallon Health | $1,233 | 506% |
| Family Life Insurance Company | $1,233 | 506% |
| Ghc Scw | $1,233 | 506% |
| Group Pension Administrators | $1,233 | 506% |
| International Benefit Administrators | $1,233 | 506% |
| Lifetime Benefit Solutions | $1,233 | 506% |
| Manhattan Life | $1,233 | 506% |
| Medi Share | $1,233 | 506% |
| Multiplan | $1,233 | 506% |
| Mvp | $1,233 | 506% |
| Pai | $1,233 | 506% |
| Pan-American Life | $1,233 | 506% |
| Paramount Hmo | $1,233 | 506% |
| Phcs | $1,233 | 506% |
| Trinity Health Share | $1,233 | 506% |
| Health Partners | $1,320 | 541% |
| Tufts Health Plan | $1,320 | 541% |
| Access Health | $1,331 | 546% |
| Acclaim | $1,331 | 546% |
| Administrative Concepts | $1,331 | 546% |
| Allegeant | $1,331 | 546% |
| Ameriben | $1,331 | 546% |
| American Family | $1,331 | 546% |
| American Healthcare Alliance | $1,331 | 546% |
| American National | $1,331 | 546% |
| American Republic | $1,331 | 546% |
| Amerihealth | $1,331 | 546% |
| Aultcare | $1,331 | 546% |
| Automated Benefit Services | $1,331 | 546% |
| Auxiant | $1,331 | 546% |
| Benefit Administrative Systems,Llc | $1,331 | 546% |
| Boon Chapman | $1,331 | 546% |
| Cam Administrative Services | $1,331 | 546% |
| Christian Brother Services | $1,331 | 546% |
| Christian Brothers Holy Cross | $1,331 | 546% |
| Comprehensive Benefits | $1,331 | 546% |
| Continental Life Insurance | $1,331 | 546% |
| Custom Benefit Administrators | $1,331 | 546% |
| Employee Benefit Concepts | $1,331 | 546% |
| Employee Benefit Management | $1,331 | 546% |
| Enterprise Group Planning | $1,331 | 546% |
| Freedom Life Insurance Company | $1,331 | 546% |
| Group Administrators | $1,331 | 546% |
| Group Marketing Services | $1,331 | 546% |
| Guardian | $1,331 | 546% |
| Health America | $1,331 | 546% |
| Healthcare Management Admin | $1,331 | 546% |
| Healthez | $1,331 | 546% |
| Humana | $1,331 | 546% |
| Insight | $1,331 | 546% |
| Intercare | $1,331 | 546% |
| Jfp Benefit Management | $1,331 | 546% |
| Jp Farley Corporation | $1,331 | 546% |
| Key Benefit Administrator | $1,331 | 546% |
| Liberty Union Life Assurance Co | $1,331 | 546% |
| Lucent Health | $1,331 | 546% |
| Luminare Health | $1,331 | 546% |
| Luminare Health (Detroit) | $1,331 | 546% |
| Magnacare | $1,331 | 546% |
| Medben | $1,331 | 546% |
| Medcost | $1,331 | 546% |
| Mutual Health Services | $1,331 | 546% |
| Mutual Of Omaha | $1,331 | 546% |
| Ncas | $1,331 | 546% |
| Nippon Life Ins | $1,331 | 546% |
| Nova | $1,331 | 546% |
| Painters Union Insurance Fund | $1,331 | 546% |
| Physicians Mutual | $1,331 | 546% |
| Plumbers Local 98 Insurance Fund | $1,331 | 546% |
| Prairie States | $1,331 | 546% |
| Preferred One | $1,331 | 546% |
| Primary Physician Care | $1,331 | 546% |
| Professional Benefit Administrators | $1,331 | 546% |
| Siho Insurance Services | $1,331 | 546% |
| The Loomis Company | $1,331 | 546% |
| Unicare | $1,331 | 546% |
| Us Health And Life | $1,331 | 546% |
| Valenz | $1,331 | 546% |
| Western & Southern Financial Group | $1,331 | 546% |
| Wps | $1,331 | 546% |
| Cigna | $1,344 | 551% |
| Coventry | $1,367 | 561% |
| First Health | $1,367 | 561% |
| Prime Health Services | $1,450 | 595% |
| Three Rivers Provider Network | $1,632 | 669% |
| Cmh Detroit Wayne Integrated Health Network | $1,813 | 744% |
| Cmh Lenawee County | $1,813 | 744% |
| Cmh Livingston County | $1,813 | 744% |
| Cmh Misc | $1,813 | 744% |
| Cmh Monroe County | $1,813 | 744% |
| Cmh Oakland County | $1,813 | 744% |
| Cmh Washtenaw County | $1,813 | 744% |