CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Upland Hills Health

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $895
Cash Discount Price: $951
vs. Medicare Baseline: 3.67x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Upland Hills Health is $895. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $951. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.67x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$951

Average discount available for prompt cash payment at this facility.

Insurance Median

$895

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: $951 (390%)

Insurance Median: $895 (367%)

Cash: $951 (390% of Medicare)

Ins. Median: $895 (367% 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 367% of the Medicare baseline (a markup of 267%). 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
Dean Health Plan	$57 - $2,224	23%
Alliance	$61 - $1,807	25%
UnitedHealthcare	$64 - $401	26%
Ghc Of Eau Claire	$223	91%
Ghc Of Sc Wi	$223 - $2,174	91%
Mhs	$223 - $895	91%
Quartz	$269	110%
Blue Cross Blue Shield	$895 - $2,622	367%
Humana	$895 - $2,877	367%
Icare	$895	367%
Medical Associates	$895 - $2,398	367%
Security Health Plan	$895	367%
Wps	$1,950 - $2,011	800%
Cigna	$2,385 - $2,666	978%
Multiplan	$2,813	1154%

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 $951.
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 Upland Hills Health 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.