CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Marshall Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $633
Cash Discount Price: $470
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Marshall Medical Center is $633. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $470. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.60x the Medicare baseline. Located in 1080 North Ellington Parkway, Lewisburg, TN.

Cash / Self-Pay

$470

Average discount available for prompt cash payment at this facility.

Insurance Median

$633

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: $470 (193%)

Insurance Median: $633 (260%)

Cash: $470 (193% of Medicare)

Ins. Median: $633 (260% 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 260% of the Medicare baseline (a markup of 160%). 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
UnitedHealthcare	$95 - $215	39%
Blue Cross Blue Shield	$146 - $618	60%
Humana	$221 - $304	91%
Wayne County Jail	$422 - $579	173%
Marshall County Jail	$633 - $868	260%
Cigna	$649	266%
Multiplan	$675 - $926	277%
Phcs	$675 - $926	277%
Firsthealth	$717 - $984	294%
Aetna	$760 - $1,042	312%

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 $470.
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 Marshall 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.