CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: University of Michigan Health - West

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,218
Cash Discount Price: $727
vs. Medicare Baseline: 5.00x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at University of Michigan Health - West is $1,218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $727. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.00x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$727

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,218

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: $727 (298%)

Insurance Median: $1,218 (500%)

Cash: $727 (298% of Medicare)

Ins. Median: $1,218 (500% 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 500% of the Medicare baseline (a markup of 400%). 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
Medicaid / KanCare	$131 - $428	54%
Molina Healthcare Of Mi	$131	54%
Care Resources	$219	90%
Humana	$244 - $1,363	100%
Insight Metro Care	$244	100%
Medicare (plans)	$244	100%
Molina Marketplace Commercial	$244	100%
Priority Health	$448	184%
Web Tpa	$799	328%
Aetna	$1,218	500%
Alliance Health & Life Ppo	$1,218	500%
Asr Physicians	$1,218	500%
Hap	$1,218	500%
Golden Rule Ins	$1,311	538%
Medica	$1,311	538%
Student Ins/Mega Life	$1,311	538%
UnitedHealthcare	$1,311	538%
Asr Cofinity	$1,518	623%
Cofinity Commercial	$1,518	623%
Cofinity Weyco	$1,518	623%
Core Source	$1,518	623%
Epoch Group	$1,518	623%
Health Partners	$1,518	623%
Hlthcomp Admin	$1,518	623%
Mid America	$1,518	623%

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 $727.
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 University of Michigan Health - West 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.