CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,345
Cash Discount Price: $2,692
vs. Medicare Baseline: 9.62x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $2,345. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,692. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.62x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$2,692

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,345

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: $2,692 (1104%)

Insurance Median: $2,345 (962%)

Cash: $2,692 (1104% of Medicare)

Ins. Median: $2,345 (962% 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 962% of the Medicare baseline (a markup of 862%). 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
The Alliance	$1,439	590%
Security Health Plan (Shp)	$1,473 - $1,637	604%
Amish/Mennonite	$1,559	640%
Quartz	$1,615	663%
Blue Cross Blue Shield	$1,757 - $2,097	721%
Wps Health Insurance	$1,907	782%
Cigna	$1,927 - $2,097	790%
Health Payment Systems	$1,972	809%
UnitedHealthcare	$2,123	871%
Humana	$2,239 - $2,522	918%
Group Health Cooperative Of Eau Claire	$2,324 - $2,692	953%
Network Health Plan	$2,366	971%
First Health	$2,409	988%
Molina Healthcare Of Wi	$2,409	988%
Trilogy	$2,551	1046%
Healtheos By Multiplan Inc.	$2,636 - $2,692	1081%
Health Partners	$2,692	1104%
Coventry	$2,721	1116%

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 $2,692.
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 - Beaver Dam (Mmc-Bd) 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.