CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Adena Fayette Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,364
Cash Discount Price: $1,028
vs. Medicare Baseline: 5.60x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Adena Fayette Medical Center is $1,364. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,028. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.60x the Medicare baseline. Located in 1430 Columbus Avenue, Washington Ch, OH.

Cash / Self-Pay

$1,028

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,364

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: $1,028 (422%)

Insurance Median: $1,364 (560%)

Cash: $1,028 (422% of Medicare)

Ins. Median: $1,364 (560% 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 560% of the Medicare baseline (a markup of 460%). 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
Blue Cross Blue Shield	$699 - $1,364	287%
Aetna	$843 - $1,629	346%
Buckeye Community Health Plan	$843	346%
Humana	$843	346%
Medical Mutual Of Ohio	$843 - $1,550	346%
Medigold	$843	346%
Molina	$843	346%
Care Source	$860	353%
Molina Marketplace	$928	381%
United Medical Resources Ohcp	$1,294	531%
UnitedHealthcare	$1,294 - $1,306	531%
Cigna	$1,417	581%
Ohio Ppo Connect	$1,440	591%
The Health Plan	$1,440	591%
Care Source Just4Me	$1,518	623%
Medical Mutual Of Ohio Supermed	$1,550	636%
First Health	$1,612	661%
Ohio Health Choice	$1,637	672%
Multiplan/Private Healthcare Systems	$1,954	802%
Sidecar Health	$2,324	953%

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 $1,028.
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 Adena Fayette 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.