CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: The McDowell Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $634
Cash Discount Price: $1,608
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at The McDowell Hospital is $634. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,608. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.60x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.

Cash / Self-Pay

$1,608

Average discount available for prompt cash payment at this facility.

Insurance Median

$634

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: $1,608 (660%)

Insurance Median: $634 (260%)

Cash: $1,608 (660% of Medicare)

Ins. Median: $634 (260% 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 260% of the Medicare baseline (a markup of 160%). 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
Blue Cross Blue Shield	$214 - $634	88%
United	$217 - $826	89%
Wellcare	$221	91%
Amerihealth	$223	91%
Partners Health Management	$225	92%
Vaya Health	$225	92%
Apex Health	$322	132%
Cigna	$551 - $860	226%
Aetna	$592 - $1,162	243%
Oscar	$698	286%
Caresource	$707	290%
Medcost	$714 - $1,367	293%
Amerihealth Caritas	$756	310%
Magellan	$965	396%
Magellan Behavioral Health	$965	396%
Multiplan	$1,286	528%
Avalon Administrative Services	$1,367	561%
Prime Health	$1,415 - $1,447	580%

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 $1,608.
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 The McDowell 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.