CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HSHS St Clare Memorial Hospital

Billing Code: 93970 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$380

about 1.6× the $244 Medicare rate · typically $153–$847

modeled estimate · not a bill or quote

What this hospital charges insurers

$381

About the fair price

about $1 over the fair price · 1.6× Medicare

Medicare pays $244 Fair price $380 This hospital $381 Cash price $1,284 Hospital's list price $1,945

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $83 Priciest $381

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Ultrasound, leg veins (duplex) is about $380 (about 1.6× the $244 Medicare rate). HSHS St Clare Memorial Hospital charges insurers about $381, or about $1,284 in cash — about the fair price. Located in Oconto Falls, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$467 - $1,945	192%
Blue Cross Blue Shieldmajor	$273 - $1,945	112%
Aetnamajor	$467 - $1,945	192%
Cignamajor	$1,216	499%
Humanamajor	$467 - $1,945	192%
Health Net	$473	194%
Meridian	$273	112%
Molina	$290 - $1,945	119%
Security Health Plan	$471 - $1,964	193%
+ 16 smaller / regional plans	$244 - $1,945

Government programs also on file: Medicaid.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,284), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 93970.

Insurance Before you use insurance

Call your insurance company to confirm HSHS St Clare Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 93970.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at HSHS St Clare Memorial Hospital

Compare: Ultrasound, leg veins (duplex) at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.