CMS Price Transparency Data
Ultrasound, leg veins (duplex)
Facility: Mercy Health Lakeshore Campus
Billing Code: 93970 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93970
- Insurance Median: $944
- Cash Discount Price: $714
- vs. Medicare Baseline: 3.87x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercy Health Lakeshore Campus is $944. 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 3.87x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$714
Average discount available for prompt cash payment at this facility.
Insurance Median
$944
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: $944 (387%)
Cash: $714 (293% of Medicare)
Ins. Median: $944 (387% 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 387% of the Medicare baseline (a markup of 287%). 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 | $180 - $938 | 74% |
| Medicaid / KanCare | $180 - $183 | 74% |
| Access Health | $192 | 79% |
| Blue Care Network Advantage | $269 | 110% |
| Medicare (plans) | $269 | 110% |
| Aetna | $274 - $874 | 112% |
| Align Senior Care | $274 | 112% |
| Correctional Recovery | $274 | 112% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $309 | 127% |
| Oscar | $337 | 138% |
| Wellpath | $357 | 146% |
| Vitalcore | $366 | 150% |
| UnitedHealthcare | $385 - $988 | 158% |
| U Of M Health Plan | $407 - $983 | 167% |
| Molina Marketplace | $457 | 187% |
| Hospice Of Michigan | $604 | 248% |
| Nomi Health | $615 | 252% |
| Hap | $823 - $1,008 | 338% |
| Wc Accident Fund | $866 | 355% |
| Wc Advantage | $866 | 355% |
| Wc Aig | $866 | 355% |
| Wc Allied | $866 | 355% |
| Wc Amerisure | $866 | 355% |
| Wc Amtrust | $866 | 355% |
| Wc Asu Risk Mgt | $866 | 355% |
| Wc Berkley Admin | $866 | 355% |
| Wc Broadspire | $866 | 355% |
| Wc Bunch & Associates | $866 | 355% |
| Wc Ccmsi | $866 | 355% |
| Wc Emc Insurance Company | $866 | 355% |
| Wc Esis | $866 | 355% |
| Wc Fcci | $866 | 355% |
| Wc Federated | $866 | 355% |
| Wc Gallagher Bassett | $866 | 355% |
| Wc Genex Care For Ohio | $866 | 355% |
| Wc Guard Insurance Company | $866 | 355% |
| Wc Hartford | $866 | 355% |
| Wc Liberty Mutual | $866 | 355% |
| Wc Meijers | $866 | 355% |
| Wc Michigan | $866 | 355% |
| Wc Mitchell Frankenmuth | $866 | 355% |
| Wc Pma | $866 | 355% |
| Wc Sedgwick | $866 | 355% |
| Wc Sentry | $866 | 355% |
| Wc Travelers | $866 | 355% |
| Wc Tristar | $866 | 355% |
| Wc Walmart | $866 | 355% |
| Wc Zurich | $866 | 355% |
| Geha | $874 - $988 | 359% |
| Meritain | $874 | 359% |
| Asr Health Benefits | $914 | 375% |
| Bcn Domestic | $938 | 385% |
| Blue Benefit Administrators Of Massachusetts | $938 | 385% |
| Blue Care Network | $938 | 385% |
| Blue Distinction Transplant | $938 | 385% |
| Blue Shield - Ca | $938 | 385% |
| Blue Shield - Id (Regence) | $938 | 385% |
| Blue Shield - Ny Highmark Northeastern | $938 | 385% |
| Blue Shield - Ny Highmark Western | $938 | 385% |
| Blue Shield - Pa (Highmark) | $938 | 385% |
| Blue Shield - Wa (Regence) | $938 | 385% |
| Health Choices | $938 - $983 | 385% |
| Kaiser Domestic | $938 | 385% |
| 1199 National Benefit Fund | $944 | 387% |
| Allied National Global Care | $944 | 387% |
| Asrm - Reliance Standard Life Insurance | $944 | 387% |
| Christian Care Ministry | $944 | 387% |
| Dean Health | $944 | 387% |
| Fallon Health | $944 | 387% |
| Family Life Insurance Company | $944 | 387% |
| Ghc Scw | $944 | 387% |
| Group Pension Administrators | $944 | 387% |
| International Benefit Administrators | $944 | 387% |
| Lifetime Benefit Solutions | $944 | 387% |
| Manhattan Life | $944 | 387% |
| Medi Share | $944 | 387% |
| Multiplan | $944 | 387% |
| Mvp | $944 | 387% |
| Pai | $944 | 387% |
| Pan-American Life | $944 | 387% |
| Paramount Hmo | $944 | 387% |
| Phcs | $944 | 387% |
| Trinity Health Share | $944 | 387% |
| Cigna | $953 | 391% |
| Caresource | $980 | 402% |
| Acclaim | $983 | 403% |
| Administrative Concepts | $983 | 403% |
| Allegeant | $983 | 403% |
| Allied Benefit Systems | $983 | 403% |
| Ameriben | $983 | 403% |
| American Family | $983 | 403% |
| American Healthcare Alliance | $983 | 403% |
| American Republic | $983 | 403% |
| Amerihealth | $983 | 403% |
| Aultcare | $983 | 403% |
| Automated Benefit Services | $983 | 403% |
| Auxiant | $983 | 403% |
| Benefit Administrative Systems,Llc | $983 | 403% |
| Boon Chapman | $983 | 403% |
| Cam Administrative Services | $983 | 403% |
| Christian Brother Services | $983 | 403% |
| Christian Brothers Holy Cross | $983 | 403% |
| Claimchoice Adminstrators | $983 | 403% |
| Comprehensive Benefits | $983 | 403% |
| Consociate | $983 | 403% |
| Continental Life Insurance | $983 | 403% |
| Custom Benefit Administrators | $983 | 403% |
| Cypress Benefit Administrators | $983 | 403% |
| Employee Benefit Concepts | $983 | 403% |
| Employee Benefit Management | $983 | 403% |
| Enterprise Group Planning | $983 | 403% |
| Forest County Potawatomi | $983 | 403% |
| Freedom Life Insurance Company | $983 | 403% |
| Group Administrators | $983 | 403% |
| Group Marketing Services | $983 | 403% |
| Guardian | $983 | 403% |
| Health America | $983 | 403% |
| Health Smart | $983 | 403% |
| Healthez | $983 | 403% |
| Healthgram | $983 | 403% |
| Healthscope | $983 | 403% |
| Humana | $983 | 403% |
| Insight | $983 | 403% |
| Intercare | $983 | 403% |
| Jfp Benefit Management | $983 | 403% |
| Jp Farley Corporation | $983 | 403% |
| Key Benefit Administrator | $983 | 403% |
| Liberty Union Life Assurance Co | $983 | 403% |
| Lucent Health | $983 | 403% |
| Luminare Health | $983 | 403% |
| Luminare Health (Detroit) | $983 | 403% |
| Medben | $983 | 403% |
| Medcost | $983 | 403% |
| Medical Mutual | $983 | 403% |
| Mutual Health Services | $983 | 403% |
| Mutual Of Omaha | $983 | 403% |
| Ncas | $983 | 403% |
| Nippon Life Ins | $983 | 403% |
| Nova | $983 | 403% |
| Painters Union Insurance Fund | $983 | 403% |
| Physicians Mutual | $983 | 403% |
| Plumbers Local 98 Insurance Fund | $983 | 403% |
| Prairie States | $983 | 403% |
| Primary Physician Care | $983 | 403% |
| Professional Benefit Administrators | $983 | 403% |
| Secureone Preferred United Plans | $983 | 403% |
| The Loomis Company | $983 | 403% |
| Trustmark Small Business Benefits | $983 | 403% |
| Unicare | $983 | 403% |
| Unified Group Services | $983 | 403% |
| Us Health And Life | $983 | 403% |
| Valenz | $983 | 403% |
| Varipro | $983 - $1,008 | 403% |
| Western & Southern Financial Group | $983 | 403% |
| Wps | $983 | 403% |
| Priority Health | $990 | 406% |
| First Health | $993 | 407% |