CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Wooster Community Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $711
  • Cash Discount Price: $946
  • vs. Medicare Baseline: 2.92x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Wooster Community Hospital is $711. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $946. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.92x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$946

Average discount available for prompt cash payment at this facility.

Insurance Median
$711

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: $946 (388%)
Insurance Median: $711 (292%)
Cash: $946 (388% of Medicare)
Ins. Median: $711 (292% 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 292% of the Medicare baseline (a markup of 192%). 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
Buckeye Mcaid-All Other Plans $132 54%
Caresource Mcaid $132 54%
UnitedHealthcare $132 - $1,055 54%
Molina Mcaid $134 55%
Blue Cross Blue Shield $135 - $1,022 55%
Aetna $138 - $1,110 57%
Amerihealth Mcaid-All Plans $138 57%
Tricare $226 93%
Buckeye Mcare $231 95%
Caresource Mcr Adv $231 95%
Humana $231 - $1,044 95%
Med Mutual Of Oh Mcr $231 95%
Molina Mcr $231 95%
Summacare Mcr $231 95%
The Health Plan Mcr Adv $231 95%
Valor Hp Mcr-All Plans $231 95%
Magnipower-All Plans $300 123%
Caresource Exch - All Other Plans $330 135%
Aultcare/Primecare Mcr Adv $383 - $544 157%
Molina Marketplace - All Other Plans $392 161%
Clarity Health - All Plans $450 185%
Cerco-All Plans $547 - $777 224%
Aultcare Wayne County $586 - $833 240%
Aultcare/Primetime Exch $586 - $833 240%
Rayco-All Plans $586 - $833 240%
Christian Health Ministries-All Plans $625 - $888 256%
Cigna $625 - $888 256%
Health Ohio Network Employer $625 - $888 256%
Wayne County-All Plans $625 - $888 256%
Healthsmart Accel $649 - $922 266%
Summacare Preferred Choice $649 - $922 266%
Health Ohio Network Ppo-All Other Plans $664 - $944 272%
Healthsmart Complete Ppo-All Other Plans $664 - $944 272%
Ohio Health Choice Supp $664 - $944 272%
Ohio Health Group Hlthy - All Other Plans $664 - $944 272%
Med Mutual Of Oh Exchange $672 - $955 276%
Med Mutual Of Oh Supermed $672 - $955 276%
Med Mutual Of Oh Trad-All Other Plans $672 - $955 276%
Health Plan Of Upper Ohio-All Plans $688 - $978 282%
The Health Plan Comm - All Other Plans $688 - $978 282%
Ohio Health Group Pref $695 - $988 285%
Aultcare/Primetime-All Other Plans $703 - $999 288%
Healthsmart Ppo $711 - $1,010 292%
Summacare-All Other Plans $727 - $1,033 298%
Ohio Health Choice-All Other Plans $735 - $1,044 302%
Healthsmart Hpo $742 - $1,055 304%
Osu-All Plans $742 - $1,055 304%
Central Benefits-All Plans $750 - $1,066 308%
First Health-All Plans $750 - $1,066 308%
Flora-All Plans $750 - $1,066 308%
Beech Street-All Plans $758 - $1,077 311%
Phcs-All Plans $758 - $1,077 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals