CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $704
Cash Discount Price: $1,004
vs. Medicare Baseline: 2.89x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Memorial Hospital is $704. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,004. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.89x the Medicare baseline. Located in 715 South Taft Avenue, Fremont, OH.

Cash / Self-Pay

$1,004

Average discount available for prompt cash payment at this facility.

Insurance Median

$704

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: $1,004 (412%)

Insurance Median: $704 (289%)

Cash: $1,004 (412% of Medicare)

Ins. Median: $704 (289% 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 289% of the Medicare baseline (a markup of 189%). 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
Aetna	$131 - $2,776	54%
Buckeye Community Health Plan	$131 - $2,776	54%
Medical Mutual Of Ohio	$131 - $1,032	54%
Meridian Health Plan Of Mi	$131 - $1,804	54%
UnitedHealthcare	$141 - $2,776	58%
Summacare	$157 - $2,146	64%
Caresource	$161 - $2,776	66%
Molina Healthcare Of Ohio	$161 - $2,776	66%
Paramount Healthcare Inc	$163 - $2,776	67%
Blue Cross Blue Shield	$166 - $2,776	68%
Frontpath	$168 - $944	69%
Health Alliance Plan	$168 - $2,776	69%
Humana	$168 - $1,804	69%
Amerihealth	$177 - $2,282	73%
Cigna	$191 - $1,374	78%
Health Ohio Network	$232 - $2,776	95%
Multiplan	$543 - $1,444	223%

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 $1,004.
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 Memorial 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.