CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Charlevoix Area Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $367
Cash Discount Price: $573
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Charlevoix Area Hospital is $367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.51x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$573

Average discount available for prompt cash payment at this facility.

Insurance Median

$367

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: $573 (235%)

Insurance Median: $367 (151%)

Cash: $573 (235% of Medicare)

Ins. Median: $367 (151% 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.

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
Mclaren Health Plan	$20 - $726	8%
Meridian	$20 - $168	8%
Priority Health	$20 - $780	8%
UnitedHealthcare	$20 - $678	8%
Blue Cross Blue Shield	$21 - $720	9%
Aetna	$32 - $704	13%
Blue Care Network	$32 - $367	13%
Hap (Health Alliance Plan)	$32 - $624	13%
Medicare (plans)	$32 - $367	13%
Michigan Amish Medical Board	$32 - $367	13%
Molina	$32 - $396	13%
Northern Michigan Mennonite Group	$32 - $367	13%
Cigna	$44 - $780	18%
Asr Physicians Care Network	$48 - $624	20%
Nomi Health	$51 - $725	21%
Employee Benefits Logistics	$54 - $623	22%
Provider Network Of America/Hma Group Health	$334 - $663	137%
Hospice Of Michigan	$341 - $468	140%
Enterprise Group Planning Employee Benefit Plan	$454 - $624	186%
First Health/Coventry Health/Community Care Network	$454 - $624	186%
Medical Cost Savings Solution	$454 - $624	186%
Three Rivers Provider Network	$483 - $663	198%
Iba Health And Life Assurance Company	$523 - $718	215%
Cofinity	$528 - $725	217%
Preferred Medical Claim Solutions	$540 - $741	222%

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 $573.
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 Charlevoix Area 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.