CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Unitypoint Health - Meriter

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $355
Cash Discount Price: $1,597
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Unitypoint Health - Meriter is $355. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,597. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.46x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$1,597

Average discount available for prompt cash payment at this facility.

Insurance Median

$355

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: $1,597 (655%)

Insurance Median: $355 (146%)

Cash: $1,597 (655% of Medicare)

Ins. Median: $355 (146% 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.

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
Aspirus	$30 - $1,928	12%
Blue Cross Blue Shield	$30 - $3,053	12%
Illinicare	$30 - $233	12%
Prevea 360	$30 - $2,732	12%
UnitedHealthcare	$30 - $1,327	12%
Humana	$31 - $233	13%
Meridiancare	$31 - $233	13%
Wellmark Uph Self-Funded	$62 - $1,855	25%
Health Partners Open Network	$63 - $1,173	26%
Medical Associates Health Plan	$127 - $1,157	52%
Cigna	$223 - $964	91%
Security Health Plan	$239 - $996	98%
Mercy Care	$279 - $1,067	114%
Quartz	$1,003	411%

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 $1,597.
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 Unitypoint Health - Meriter 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.