CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Forks Community Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $809
Cash Discount Price: $1,340
vs. Medicare Baseline: 3.32x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Forks Community Hospital is $809. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,340. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.32x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$1,340

Average discount available for prompt cash payment at this facility.

Insurance Median

$809

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: $1,340 (550%)

Insurance Median: $809 (332%)

Cash: $1,340 (550% of Medicare)

Ins. Median: $809 (332% 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 332% of the Medicare baseline (a markup of 232%). 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
Medicaid / KanCare	$280 - $931	115%
Coordinated Care (Mco) Mcd-All Plans	$302 - $949	124%
Medicare (plans)	$318	130%
UnitedHealthcare	$360 - $2,160	148%
Community Health Network Mcr-All Other Plans	$364 - $1,143	149%
Humana	$364 - $1,143	149%
Tricare	$364 - $1,143	149%
Triwest-All Plans	$364 - $1,143	149%
Ambetter / Centene	$422 - $1,326	173%
Wellcare Med Adv - All Plans	$422 - $1,326	173%
Regence-All Other Plans	$466 - $1,463	191%
Community Health Exchange	$526 - $1,652	216%
Molina Commercial-All Other Plans	$744 - $2,338	305%
Aetna	$769 - $2,414	315%
Blue Cross Blue Shield	$769 - $2,414	315%
Cigna	$809 - $2,541	332%
First Choice-All Plans	$809 - $2,541	332%

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 $1,340.
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 Forks 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.