CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Wheatland Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,106
  • Cash Discount Price: $854
  • vs. Medicare Baseline: 4.54x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Wheatland Memorial Hospital is $1,106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $854. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.54x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.
Cash / Self-Pay
$854

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,106

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: $854 (350%)
Insurance Median: $1,106 (454%)
Cash: $854 (350% of Medicare)
Ins. Median: $1,106 (454% 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 454% of the Medicare baseline (a markup of 354%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $32 - $52 13%
Healthnet Federal-All Plans $32 - $1,595 13%
Humana $32 - $1,595 13%
Pacific Source Mcr Adv $32 - $1,595 13%
Triwest-All Plans $32 - $1,595 13%
UnitedHealthcare $32 - $2,563 13%
Medica Prime Solutions-All Plans $33 - $1,595 14%
Naphcare-All Plans $51 21%
Allegiance Provider-All Plans $53 - $2,223 22%
First Choice Big Sky-All Plans $53 - $2,485 22%
City Of Billings-All Plans $54 - $3,923 22%
Community Health Ntwk-All Plans $57 - $2,485 23%
Interwest Ppo-All Plans $57 - $2,485 23%
6 Degrees Health-All Plans $58 - $2,485 24%
Ccn-All Plans $58 - $2,537 24%
First Health-All Plans $58 - $2,511 24%
Mountain Health Co-Op-All Plans $58 - $2,485 24%
Rocky Mountain Health Network-All Plans $58 - $2,485 24%
Pacific Source-All Other Plans $59 - $2,485 24%
Pacific Steel & Recycling-All Plans $59 - $2,485 24%
Amish Old Orders-All Plans $70 - $1,962 29%
Fedmed Network-All Plans $80 - $2,485 33%
Americas Choice-All Plans $89 - $2,485 37%
Three Rivers-All Plans $89 - $2,485 37%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 3Rd St Nw, Harlowton, MT 59036
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals