CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Highland District Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $160
Cash Discount Price: $386
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Highland District Hospital is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $386. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.66x the Medicare baseline. Located in 1275 North High Street, Hillsboro, OH.

Cash / Self-Pay

$386

Average discount available for prompt cash payment at this facility.

Insurance Median

$160

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: $386 (158%)

Insurance Median: $160 (66%)

Cash: $386 (158% of Medicare)

Ins. Median: $160 (66% 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.

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
Highland_County_Sheriff_Dept	$93	38%
Medicaid / KanCare	$93 - $97	38%
Blue Cross Blue Shield	$95 - $366	39%
Humana	$95 - $427	39%
Medicare (plans)	$154 - $159	63%
UnitedHealthcare	$154	63%
Aetna	$157 - $391	64%
Medigold	$162	66%
Immergrun_Amish	$386	158%
Medben	$386	158%
Central_Benefits_Commercial	$434	178%
Cigna	$434	178%
Medical_Mutual_Commercial	$439	180%
Uhc_	$443	182%

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 $386.
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 Highland District 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.