CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Holy Family Memorial

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $887
  • Cash Discount Price: $820
  • vs. Medicare Baseline: 3.64x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Holy Family Memorial is $887. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $820. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.64x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
$820

Average discount available for prompt cash payment at this facility.

Insurance Median
$887

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: $820 (336%)
Insurance Median: $887 (364%)
Cash: $820 (336% of Medicare)
Ins. Median: $887 (364% 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 364% of the Medicare baseline (a markup of 264%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $230 - $880 94%
Community Care Incorporated $230 94%
Health Partners $230 - $969 94%
Humana $230 94%
Icare $230 94%
Molina $230 - $248 94%
Network Health Plan $230 - $536 94%
Security Health Plan $230 - $1,193 94%
UnitedHealthcare $230 - $807 94%
Allwell $234 96%
Medical College Of Wisconsin $492 202%
Centivo $596 - $686 244%
Dean Health Plan $746 306%
Health Payment Systems $841 345%
Sheboygan Employers Health Network $895 367%
Chorus Community Health Plan $959 393%
Trilogy $984 404%
Cigna $1,074 441%
Wps Health Plan $1,103 452%
Aspirus $1,193 489%
Healtheos $1,193 489%
Multiplan/Private Healthcare Systems $1,193 489%
Preferred One $1,193 489%
Healthsmart $1,238 508%
First Health Network $1,312 538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals