CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Holland Community Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $594
Cash Discount Price: $1,114
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Holland Community Hospital is $594. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,114. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.44x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$1,114

Average discount available for prompt cash payment at this facility.

Insurance Median

$594

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: $1,114 (457%)

Insurance Median: $594 (244%)

Cash: $1,114 (457% of Medicare)

Ins. Median: $594 (244% 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 244% of the Medicare baseline (a markup of 144%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Life Circles-All Plans	$226	93%
Health Alliance Mcr Adv	$238	98%
Ph Mcr Adv	$238	98%
Va Ccn - All Plans	$238	98%
Aetna	$245 - $1,485	101%
Longevity Health Plan-All Plans	$257	105%
Cigna	$343	141%
Priority Health - All Other Plans	$379	155%
Health Alliance Hmo	$539	221%
Sisco Epi	$561	230%
Sisco-All Other Plans	$561	230%
Asr - All Plans	$563	231%
Health Alliance Ahl - All Other Plans	$563	231%
Molina Mcaid - All Plans	$594	244%
Ph Mcaid	$594	244%
Blue Cross Blue Shield	$953	391%
Nomi Health - All Plans	$1,021	419%
Cofinity -All Plans	$1,299	533%
Multiplan - All Plans	$1,615	663%
Benefit Source Inc-All Plans	$1,670	685%
First Health-All Plans	$1,670	685%
Usa Managed Care-All Plans	$1,670	685%
Integrated Health Plans-All Plans	$1,763	723%
UnitedHealthcare	$1,856	761%

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 $1,114.
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 Holland 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.