CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Lafollette Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $310
  • Cash Discount Price: $589
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Lafollette Medical Center is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $589. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.27x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$589

Average discount available for prompt cash payment at this facility.

Insurance Median
$310

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: $589 (242%)
Insurance Median: $310 (127%)
Cash: $589 (242% of Medicare)
Ins. Median: $310 (127% 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.

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
Medicaid / KanCare $90 - $558 37%
UnitedHealthcare $90 - $2,233 37%
Blue Cross Blue Shield $115 - $618 47%
Bluecare $117 - $133 48%
Amerigroup $181 74%
Tricare $211 87%
Veterans Eval Services $216 89%
Node Champva $223 91%
Triwest $227 93%
Humana $228 - $491 94%
Medicare (plans) $228 94%
Node Bluecare Plus Tn Mcr Adv $228 94%
Node Hospice Non Par Agree $232 95%
Node Va $232 95%
Node Wellcare Mcr Adv $232 95%
Node Devoted Health Mcr Adv $233 96%
Node Farm Bureau Mcr Adv $233 96%
Aetna $235 - $1,389 96%
Node Blueadvantage Mcr Adv $235 96%
Node Healthspring Mcr Adv $235 96%
Node Amerigroup Mcr Adv $240 98%
Windsor Health Plan $240 98%
Node Nhc Mcr Adv $251 103%
Node Us Dept Of Labor $290 119%
Cigna $317 130%
Novanet Work Comp Tn $359 147%
Tn Work Comp $363 149%
Ambetter / Centene $429 176%
Wellcare $436 - $558 179%
Self Pay $501 - $641 206%
Node Point Comfort Underwriters $510 209%
Multiplan Complementary $1,326 - $1,697 544%
Beech Street Work Comp Tn $36,200 14850%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals