CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Fairfield Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,392
Cash Discount Price: $901
vs. Medicare Baseline: 5.71x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Fairfield Medical Center is $1,392. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $901. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.71x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$901

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,392

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: $901 (370%)

Insurance Median: $1,392 (571%)

Cash: $901 (370% of Medicare)

Ins. Median: $1,392 (571% 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 571% of the Medicare baseline (a markup of 471%). 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
Medicaid / KanCare	$139	57%
Molina	$139 - $10,071	57%
UnitedHealthcare	$139 - $6,104	57%
Caresource	$141 - $7,935	58%
Blue Cross Blue Shield	$143 - $26,250	59%
Humana	$145 - $5,983	59%
Amerihealth Caritas Ohio	$146	60%
Buckeye Community Health	$146 - $9,461	60%
Aetna	$226 - $5,983	93%
Medical Mutual	$226 - $33,500	93%
Medicare (plans)	$226 - $5,983	93%
Medigold	$230 - $6,104	94%
Va Ccn	$230 - $6,104	94%
The Health Plan	$231 - $6,102	95%
Valor Health Plan	$231 - $6,102	95%
Bwc	$320 - $8,478	131%
Oscar	$426 - $6,299	175%
Allied Benefit Systems	$1,392	571%
Meritain Health	$1,392	571%
Quality Care Partners/Ohio Ppo Connect	$1,442	592%
The Ohio State Health Plan	$1,542	633%
Cigna	$1,650	677%
Ohio Healthy	$1,883	772%
Multiplan	$1,903	781%
Miscellaneous Plans	$2,003	822%

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 $901.
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 Fairfield Medical Center 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.