CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $642
  • Cash Discount Price: $642
  • vs. Medicare Baseline: 2.63x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Rehabilitation Hospital of Wisconsin is $642. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $642. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.63x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$642

Average discount available for prompt cash payment at this facility.

Insurance Median
$642

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: $642 (263%)
Insurance Median: $642 (263%)
Cash: $642 (263% of Medicare)
Ins. Median: $642 (263% 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 263% of the Medicare baseline (a markup of 163%). 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
Alliance Ppo $443 182%
Dean Ppo Hmo/Pos $443 182%
Medica (Under Dean) $443 182%
UnitedHealthcare $450 - $642 185%
Trilogy Ppo $462 - $642 190%
Wps "Insurance" Ppo $469 192%
Phcs Savility $482 198%
Hps Solutions Ppo $488 200%
Aetna $501 - $642 206%
Health Eos Poc $514 211%
Coventry/First Health Ppo $527 216%
Hps (Other) $527 216%
Health Eos Multiplan $546 224%
Phcs / Multiplan $591 242%
All Savers $642 263%
Blue Cross Blue Shield $642 263%
Centivo Broad $642 263%
Centivo Intermediate/Median $642 263%
Centivo Narrow/Value $642 263%
Children'S Communty Health Plan(Cchp) $642 263%
Cigna $642 263%
Community Care, Inc $642 263%
Humana $642 263%
Icare Mcd $642 263%
Managed Health Services (Mhs) $642 263%
Medicaid / KanCare $642 263%
Medicare (plans) $642 263%
Molina (Fka Care Wisconsin) $642 263%
Network Health - Aca $642 263%
Network Health - Commercial $642 263%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $642 263%
Security Health Plan - Advocare $642 263%
Together With Cchp $642 263%
Unity Health Plan And Unity Quartz(Hmo/Pos) $642 263%
Va - Primary Only - Authorization Required $642 263%
Wellcare Mcr $642 263%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1625 Coldwater Creek Dr, Waukesha, WI 53188
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL