CMS Price Transparency Data
Ultrasound, leg veins (duplex)
Facility: Trinity Health Muskegon Hospital
Billing Code: 93970 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93970
- Insurance Median: $824
- Cash Discount Price: $714
- vs. Medicare Baseline: 3.38x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Trinity Health Muskegon Hospital is $824. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $714. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.38x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$714
Average discount available for prompt cash payment at this facility.
Insurance Median
$824
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: $714 (293%)
Insurance Median: $824 (338%)
Cash: $714 (293% of Medicare)
Ins. Median: $824 (338% 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 338% of the Medicare baseline (a markup of 238%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $133 - $1,304 | 55% |
| Medicaid / KanCare | $133 - $136 | 55% |
| Access Health | $178 | 73% |
| Aetna | $250 - $744 | 103% |
| Blue Care Network Advantage | $250 | 103% |
| Medicare (plans) | $250 | 103% |
| Align Senior Care | $255 | 105% |
| Correctional Recovery | $255 | 105% |
| Heartland Hospice | $255 | 105% |
| Hospice Harbor Hospice | $255 | 105% |
| UnitedHealthcare | $262 - $966 | 107% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $287 | 118% |
| Oscar | $326 | 134% |
| Molina Marketplace | $331 | 136% |
| Vitalcore | $395 | 162% |
| Wellpath | $395 | 162% |
| U Of M Health Plan | $407 - $865 | 167% |
| Priority Health | $408 - $481 | 167% |
| Acs Benefit Services | $571 | 234% |
| Allied Benefit Systems | $571 | 234% |
| Claimchoice Adminstrators | $571 | 234% |
| Consociate | $571 | 234% |
| Cypress Benefit Administrators | $571 | 234% |
| Forest County Potawatomi | $571 | 234% |
| Health Smart | $571 | 234% |
| Healthgram | $571 | 234% |
| Healthscope | $571 | 234% |
| Preferred One | $571 | 234% |
| Secureone Preferred United Plans | $571 | 234% |
| Sisco Benefits | $571 | 234% |
| The Health Plan | $571 | 234% |
| Trustmark Small Business Benefits | $571 | 234% |
| Unified Group Services | $571 | 234% |
| Webtpa | $571 | 234% |
| Asr Health Benefits | $583 | 239% |
| Hap | $583 - $870 | 239% |
| Wc Accident Fund | $586 | 240% |
| Wc Advantage | $586 | 240% |
| Wc Aig | $586 | 240% |
| Wc Allied | $586 | 240% |
| Wc Amerisure | $586 | 240% |
| Wc Amtrust | $586 | 240% |
| Wc Asu Risk Mgt | $586 | 240% |
| Wc Berkley Admin | $586 | 240% |
| Wc Broadspire | $586 | 240% |
| Wc Bunch & Associates | $586 | 240% |
| Wc Ccmsi | $586 | 240% |
| Wc Emc Insurance Company | $586 | 240% |
| Wc Esis | $586 | 240% |
| Wc Fcci | $586 | 240% |
| Wc Federated | $586 | 240% |
| Wc Gallagher Bassett | $586 | 240% |
| Wc Genex Care For Ohio | $586 | 240% |
| Wc Guard Insurance Company | $586 | 240% |
| Wc Hartford | $586 | 240% |
| Wc Liberty Mutual | $586 | 240% |
| Wc Meijers | $586 | 240% |
| Wc Michigan | $586 | 240% |
| Wc Mitchell Frankenmuth | $586 | 240% |
| Wc Pma | $586 | 240% |
| Wc Sedgwick | $586 | 240% |
| Wc Sentry | $586 | 240% |
| Wc Travelers | $586 | 240% |
| Wc Tristar | $586 | 240% |
| Wc Walmart | $586 | 240% |
| Wc Zurich | $586 | 240% |
| Hospice Of Michigan | $604 | 248% |
| Nomi Health | $615 | 252% |
| Varipro | $635 | 260% |
| Caresource | $691 | 283% |
| Cigna | $691 | 283% |
| Geha | $744 - $966 | 305% |
| Meritain | $744 | 305% |
| 1199 National Benefit Fund | $824 | 338% |
| Allied National Global Care | $824 | 338% |
| Asrm - Reliance Standard Life Insurance | $824 | 338% |
| Christian Care Ministry | $824 | 338% |
| Dean Health | $824 | 338% |
| Fallon Health | $824 | 338% |
| Family Life Insurance Company | $824 | 338% |
| Ghc Scw | $824 | 338% |
| Group Pension Administrators | $824 | 338% |
| International Benefit Administrators | $824 | 338% |
| Lifetime Benefit Solutions | $824 | 338% |
| Manhattan Life | $824 | 338% |
| Medi Share | $824 | 338% |
| Multiplan | $824 | 338% |
| Mvp | $824 | 338% |
| Pai | $824 | 338% |
| Pan-American Life | $824 | 338% |
| Paramount Hmo | $824 | 338% |
| Phcs | $824 | 338% |
| Trinity Health Share | $824 | 338% |
| Acclaim | $865 | 355% |
| Administrative Concepts | $865 | 355% |
| Allegeant | $865 | 355% |
| Ameriben | $865 | 355% |
| American Family | $865 | 355% |
| American Healthcare Alliance | $865 | 355% |
| American Republic | $865 | 355% |
| Amerihealth | $865 | 355% |
| Aultcare | $865 | 355% |
| Automated Benefit Services | $865 | 355% |
| Auxiant | $865 | 355% |
| Benefit Administrative Systems,Llc | $865 | 355% |
| Boon Chapman | $865 | 355% |
| Cam Administrative Services | $865 | 355% |
| Christian Brother Services | $865 | 355% |
| Christian Brothers Holy Cross | $865 | 355% |
| Comprehensive Benefits | $865 | 355% |
| Continental Life Insurance | $865 | 355% |
| Custom Benefit Administrators | $865 | 355% |
| Employee Benefit Concepts | $865 | 355% |
| Employee Benefit Management | $865 | 355% |
| Enterprise Group Planning | $865 | 355% |
| Freedom Life Insurance Company | $865 | 355% |
| Group Administrators | $865 | 355% |
| Group Marketing Services | $865 | 355% |
| Guardian | $865 | 355% |
| Health America | $865 | 355% |
| Health Choices | $865 - $1,304 | 355% |
| Healthez | $865 | 355% |
| Humana | $865 | 355% |
| Insight | $865 | 355% |
| Intercare | $865 | 355% |
| Jfp Benefit Management | $865 | 355% |
| Jp Farley Corporation | $865 | 355% |
| Key Benefit Administrator | $865 | 355% |
| Liberty Union Life Assurance Co | $865 | 355% |
| Lucent Health | $865 | 355% |
| Luminare Health | $865 | 355% |
| Luminare Health (Detroit) | $865 | 355% |
| Medben | $865 | 355% |
| Medcost | $865 | 355% |
| Medical Mutual | $865 | 355% |
| Mutual Health Services | $865 | 355% |
| Mutual Of Omaha | $865 | 355% |
| Ncas | $865 | 355% |
| Nippon Life Ins | $865 | 355% |
| Nova | $865 | 355% |
| Painters Union Insurance Fund | $865 | 355% |
| Physicians Mutual | $865 | 355% |
| Plumbers Local 98 Insurance Fund | $865 | 355% |
| Prairie States | $865 | 355% |
| Primary Physician Care | $865 | 355% |
| Professional Benefit Administrators | $865 | 355% |
| The Loomis Company | $865 | 355% |
| Unicare | $865 | 355% |
| Us Health And Life | $865 | 355% |
| Valenz | $865 | 355% |
| Western & Southern Financial Group | $865 | 355% |
| Wps | $865 | 355% |
| First Health | $901 | 370% |
| Barinet | $1,098 | 450% |
| Cmh Allegan County | $1,098 | 450% |
| Cmh Barry County | $1,098 | 450% |
| Cmh Berrien County | $1,098 | 450% |
| Cmh Cass County | $1,098 | 450% |
| Cmh Kalamazoo | $1,098 | 450% |
| Cmh Kent County | $1,098 | 450% |
| Cmh Misc | $1,098 | 450% |
| Cmh Muskegon County | $1,098 | 450% |
| Cmh North Country | $1,098 | 450% |
| Cmh Northern Lakes County | $1,098 | 450% |
| Cmh Ottawa County | $1,098 | 450% |
| Cmh Van Buren County | $1,098 | 450% |
| Cmh West Mi County | $1,098 | 450% |
| Bcn Domestic | $1,304 | 535% |
| Blue Benefit Administrators Of Massachusetts | $1,304 | 535% |
| Blue Care Network | $1,304 | 535% |
| Blue Distinction Transplant | $1,304 | 535% |
| Blue Shield - Ca | $1,304 | 535% |
| Blue Shield - Id (Regence) | $1,304 | 535% |
| Blue Shield - Ny Highmark Northeastern | $1,304 | 535% |
| Blue Shield - Ny Highmark Western | $1,304 | 535% |
| Blue Shield - Pa (Highmark) | $1,304 | 535% |
| Blue Shield - Wa (Regence) | $1,304 | 535% |
| Kaiser Domestic | $1,304 | 535% |