CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Licking Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,513
  • Cash Discount Price: $2,022
  • vs. Medicare Baseline: 6.21x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Licking Memorial Hospital is $1,513. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,022. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.21x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$2,022

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,513

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: $2,022 (829%)
Insurance Median: $1,513 (621%)
Cash: $2,022 (829% of Medicare)
Ins. Median: $1,513 (621% 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 621% of the Medicare baseline (a markup of 521%). 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
Tricare $225 92%
Aetna $230 - $2,777 94%
Blue Cross Blue Shield $230 - $2,888 94%
Champva [500001] $230 94%
Cigna $230 - $3,026 94%
Humana $230 - $3,261 94%
Medicare (plans) $230 94%
UnitedHealthcare $230 - $2,858 94%
Veterans Administration [100068] $230 94%
Wellcare By Allwell [450104] $230 94%
Molina Marketplace [100106] $368 151%
Medical Mutual [100114] $650 - $2,790 267%
Medben [700068] $827 - $3,295 339%
Benicomp [70090] $886 - $2,521 363%
Consociate Health 6 Degrees [100059] $945 - $2,690 388%
Consociate Health [100029] $945 - $2,690 388%
Allied Benefit Systems [100015] $966 - $2,750 396%
Geha [100039] $966 - $2,750 396%
Gravie Administrative Services [100165] $966 - $2,750 396%
Meritain [100063] $966 - $2,750 396%
Optima [700069] $966 - $2,750 396%
Trustmark Small Business Benefits [100263] $966 - $2,750 396%
Webtpa [100127] $966 - $2,750 396%
Healthscope [100157] $1,004 - $2,858 412%
Surest [100016] $1,004 - $2,858 412%
United Medical Resources [700071] $1,004 - $2,858 412%
American Postal Workers [100089] $1,063 - $3,026 436%
Antidote Health Plan Of Ohio [70006803] $1,063 - $3,026 436%
Coresource [100002] $1,063 - $3,362 436%
Great West Life [700064] $1,063 - $3,026 436%
National Association Of Letter Carriers [100067] $1,063 - $3,026 436%
Ohio Healthy Luminare Health [100264] $1,063 - $3,026 436%
Ohio Healthy [100255] $1,063 - $3,026 436%
Ohio Ppo Connect [70006801] $1,063 - $3,026 436%
Osu Prime Care [100254] $1,063 - $3,026 436%
Quality Care Partners [70006802] $1,063 - $3,026 436%
The Health Plan [100261] $1,063 - $3,026 436%
Wellfleet Group, Llc [100164] $1,063 - $3,026 436%
Coventry [100010] $1,090 - $3,103 447%
Pan American Life [700070] $1,090 - $3,103 447%
Ohio Health Choice [100109] $1,134 - $3,227 465%
Administrative Concepts [100006] $1,146 - $3,261 470%
Carefactor [100087] $1,146 - $3,261 470%
Philadelphia American Life [100260] $1,146 - $3,362 470%
Reliance Standard-Asrm [100258] $1,146 - $3,261 470%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals