CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,025
Cash Discount Price: $1,057
vs. Medicare Baseline: 4.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at University of Wi Hospitals & Clinics Authority is $1,025. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,057. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.20x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.

Cash / Self-Pay

$1,057

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,025

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: $1,057 (434%)

Insurance Median: $1,025 (420%)

Cash: $1,057 (434% of Medicare)

Ins. Median: $1,025 (420% 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 420% of the Medicare baseline (a markup of 320%). 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
Aetna	$244 - $1,412	100%
Blue Cross Blue Shield	$244 - $1,673	100%
Humana	$244	100%
Medicare (plans)	$244 - $249	100%
UnitedHealthcare	$244 - $1,102	100%
Alliance_Premier_Network	$841	345%
Mercycare	$873	358%
Triology	$898 - $1,074	368%
Security_Health_Plan	$951 - $1,118	390%
Employer'S_Coalition_On_Health	$969 - $1,356	398%
Alliance	$990	406%
Hfn	$1,004 - $1,356	412%
United_Healthcare	$1,009 - $1,495	414%
Beloit_Health_System	$1,021	419%
Aspirus_Health_Plan	$1,028	422%
Cigna	$1,057	434%
Health_Partners_Insurance	$1,074	441%
Health_Payment_Systems	$1,079	443%
Dean_Health_Plan	$1,127	462%
Medical_Associates	$1,162	477%
Wps	$1,220 - $1,344	500%
Employers_Healthcare_Coalition_Of_Wi	$1,233	506%
Aspirus_Network_Inc	$1,356	556%
Chorus_Community	$1,409	578%
Ghc_Eau_Claire_Health_Plan	$1,409	578%
Multiplan	$1,409 - $1,620	578%
Sheybogan_Employers_Health_Network	$1,409	578%
Coventry	$1,497	614%
Dean_Care	$1,497	614%
Healthsmart	$1,550	636%

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 $1,057.
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 University of Wi Hospitals & Clinics Authority 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.