CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Black River Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $656
Cash Discount Price: $1,318
vs. Medicare Baseline: 2.69x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Black River Memorial Hospital is $656. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,318. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.69x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$1,318

Average discount available for prompt cash payment at this facility.

Insurance Median

$656

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: $1,318 (541%)

Insurance Median: $656 (269%)

Cash: $1,318 (541% of Medicare)

Ins. Median: $656 (269% 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 269% of the Medicare baseline (a markup of 169%). 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
Blue Cross Blue Shield	$28 - $1,423	11%
My Choice Wisconsin, Inc.	$28 - $825	11%
Quartz Health Solutions, Inc	$28 - $1,471	11%
Security Health Plan	$28 - $1,510	11%
The Alliance	$28 - $1,552	11%
UnitedHealthcare	$28 - $1,525	11%
Group Health Cooperative Of Eau Claire	$30 - $1,568	12%
Humana	$30 - $1,504	12%
Multiplan	$85 - $1,601	35%
Corvel	$401 - $986	164%
Triology Health Solutions	$592 - $1,536	243%
Medica	$615 - $1,510	252%
Association Benefits Solution	$625 - $1,536	256%
Family Health Center Of Marshfield	$625 - $1,536	256%
First Health Group Corporation	$625 - $1,536	256%
Provider Network Of America	$625 - $1,536	256%
Cigna	$638 - $1,568	262%
Cofinity	$638 - $1,568	262%
Coventry Health Care	$638 - $1,568	262%
Custom Benefit Administrators	$638 - $1,568	262%
Healthpartners, Inc.	$638 - $1,568	262%
Wisconsin Physicians Service Insurance Corp	$638 - $1,568	262%
Chorus	$645 - $1,585	265%

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 $1,318.
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 Black River Memorial Hospital 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.