CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Wilkes Regional Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $579
  • Cash Discount Price: $568
  • vs. Medicare Baseline: 2.38x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Wilkes Regional Medical Center is $579. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $568. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.38x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.
Cash / Self-Pay
$568

Average discount available for prompt cash payment at this facility.

Insurance Median
$579

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: $568 (233%)
Insurance Median: $579 (238%)
Cash: $568 (233% of Medicare)
Ins. Median: $579 (238% 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 238% of the Medicare baseline (a markup of 138%). 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
Amerihealth $212 - $659 87%
Carolina Complete $212 87%
Healthblue $212 87%
Partners $212 87%
UnitedHealthcare $215 - $606 88%
Vaya $215 88%
Wellcare $215 88%
Alliance $217 89%
Trillium $219 90%
Healthteam $238 98%
Medcost $327 - $810 134%
Blue Cross Blue Shield $351 - $662 144%
Aetna $431 - $780 177%
Ambetter / Centene $480 - $691 197%
Cigna $595 - $615 244%
Oscar $624 - $738 256%
Directnet $671 275%
Private Healthcare Systems $1,022 419%
Multiplan $1,044 428%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1370 West D St, North Wilkesboro, NC 28659
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals