CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Community Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,249
  • Cash Discount Price: $996
  • vs. Medicare Baseline: 5.12x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Community Memorial Hospital is $1,249. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $996. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.12x the Medicare baseline. Located in W180 N8085 Town Hall Rd, Menomonee Falls, WI.
Cash / Self-Pay
$996

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,249

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: $996 (409%)
Insurance Median: $1,249 (512%)
Cash: $996 (409% of Medicare)
Ins. Median: $1,249 (512% 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 512% of the Medicare baseline (a markup of 412%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Allwell $235 96%
Blue Cross Blue Shield $235 - $1,538 96%
Community Care $235 96%
Health Partners $235 - $1,176 96%
Humana $235 96%
Icare $235 96%
Network Health Plan $235 - $536 96%
Security Health Plan $235 96%
UnitedHealthcare $235 - $807 96%
Aetna $239 - $1,267 98%
Care Wisconsin/Mychoice $242 99%
Centivo $543 - $597 223%
Sheboygan Employers Health Network $597 245%
Froedtert South $760 312%
Chorus Community Health Plan $778 319%
Common Ground $1,086 446%
Trilogy $1,249 512%
Health Payment Systems $1,259 516%
Wisconsin Physician Services $1,267 520%
Aspirus $1,448 594%
Ibsi Passport $1,466 601%
Americas Choice $1,575 646%
Federated Mutual $1,575 646%
Healtheos $1,575 646%
Multiplan/Private Healthcare Systems $1,575 646%
Savility $1,575 646%
Cigna $1,593 653%
First Health Network $1,593 653%
Healthsmart $1,629 668%
Physicians Plus $1,629 668%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: W180 N8085 Town Hall Rd, Menomonee Falls, WI 53051
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals