CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Fostoria Community Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,107
Cash Discount Price: $1,384
vs. Medicare Baseline: 4.54x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Fostoria Community Hospital is $1,107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,384. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.54x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$1,384

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,107

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: $1,384 (568%)

Insurance Median: $1,107 (454%)

Cash: $1,384 (568% of Medicare)

Ins. Median: $1,107 (454% 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 454% of the Medicare baseline (a markup of 354%). 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
Meridian Health Plan Of Mi	$131	54%
Paramount Health Care	$163 - $1,128	67%
Blue Cross Blue Shield	$168 - $1,380	69%
Health Alliance Plan	$168 - $1,597	69%
Health Value Management	$168 - $461	69%
Buckeye Community Health Plan	$173 - $475	71%
Buckeye Community Health Plan Inc	$191 - $773	78%
Aetna	$193 - $1,426	79%
Dayton Area Health Plan Dba Caresource	$219 - $884	90%
UnitedHealthcare	$221 - $1,273	91%
Amerihealth	$232	95%
Veterans Affairs	$468	192%
Medical Mutual Of Ohio	$1,203 - $1,280	493%
Frontpath Health Coalition	$1,226	503%
Ohio Health Choice	$1,384	568%
Ohio Ppo Connect	$1,384 - $1,597	568%
Health Ohio Network	$1,682	690%
Connecticut General Life Insurance Company	$1,699	697%

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 $1,384.
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 Fostoria Community 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.