CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Marshfield Medical Center - Rice Lake

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,197
Cash Discount Price: $1,197
vs. Medicare Baseline: 4.91x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Marshfield Medical Center - Rice Lake is $1,197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,197. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.91x the Medicare baseline. Located in 1700 West Stout Street, Rice Lake, WI.

Cash / Self-Pay

$1,197

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,197

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: $1,197 (491%)

Insurance Median: $1,197 (491%)

Cash: $1,197 (491% of Medicare)

Ins. Median: $1,197 (491% 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 491% of the Medicare baseline (a markup of 391%). 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
Family Health Center (Fhc)	$630	258%
Security Health Plan (Shp)	$674 - $922	276%
Amish/Mennonite	$693	284%
Sanford Health Plan	$693	284%
The Alliance	$890 - $1,197	365%
Blue Cross Blue Shield	$983 - $1,134	403%
Group Health Cooperative Of Eau Claire	$1,033 - $1,210	424%
UnitedHealthcare	$1,038	426%
Molina Healthcare Of Wi	$1,071	439%
Besse Forest Products	$1,197	491%
Cigna	$1,197	491%
Corvel	$1,197	491%
First Health	$1,197	491%
Health Partners	$1,197	491%
Healtheos By Multiplan Inc.	$1,197	491%
Rice Lake School District	$1,197	491%
Medica Of Wi	$1,203 - $1,227	493%
Trilogy	$1,203 - $1,210	493%
Coventry	$1,210	496%
Health Smart	$1,210	496%
Rising Medical Work Comp	$1,222	501%
Wps Health Insurance	$1,228	504%
Three Rivers Provider Network (Trpn)	$1,235	507%

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 $1,197.
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 Marshfield Medical Center - Rice Lake 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.