CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Beloit Health System

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,027
Cash Discount Price: $593
vs. Medicare Baseline: 4.21x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Beloit Health System is $1,027. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $593. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.21x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.

Cash / Self-Pay

$593

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,027

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: $593 (243%)

Insurance Median: $1,027 (421%)

Cash: $593 (243% of Medicare)

Ins. Median: $1,027 (421% 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 421% of the Medicare baseline (a markup of 321%). 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	$32 - $2,060	13%
Blue Cross Blue Shield	$32 - $1,409	13%
Dean Health	$32 - $1,232	13%
Independent Care Health Plan	$32 - $251	13%
Quartz	$32 - $1,409	13%
UnitedHealthcare	$32 - $1,626	13%
Cook Children'S Health Plan (Cchp)	$34 - $251	14%
Naphcare	$47 - $1,301	19%
The Alliance	$79 - $1,027	32%
Humana	$118 - $1,626	48%
Wps	$126 - $1,606	52%
Wea Trust	$245 - $1,193	101%
Managed Health Services	$251	103%
Molina Healthcare	$251	103%
Wellcare	$251	103%
Multiplan	$356 - $1,735	146%
Health Eos	$405 - $1,973	166%
Cigna	$423 - $2,060	174%
Hfn	$423 - $2,060	174%
Preferred Network Access	$423 - $2,060	174%

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 $593.
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 Beloit Health System 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.