CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Childrens Hospital of Wisconsin

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $2,070
  • Cash Discount Price: $1,345
  • vs. Medicare Baseline: 8.49x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Childrens Hospital of Wisconsin is $2,070. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,345. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.49x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$1,345

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,070

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: $1,345 (552%)
Insurance Median: $2,070 (849%)
Cash: $1,345 (552% of Medicare)
Ins. Median: $2,070 (849% 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 849% of the Medicare baseline (a markup of 749%). 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.

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
Froedtert Health $1,712 - $2,079 702%
Medical College Of Wisconsin $1,712 702%
Network Health Plan $1,742 715%
UnitedHealthcare $1,798 - $1,862 738%
Aspirus Health Plan $1,835 753%
Common Ground Healthcare Cooperative $1,835 - $2,079 753%
Trilogy Health Solutions $1,835 - $2,079 753%
Wps Health Plan $1,859 - $2,202 763%
Advocate Aurora Healthcare $1,884 773%
Blue Cross Blue Shield $1,908 - $2,324 783%
Centivo $1,908 783%
Health Partners $1,908 - $2,153 783%
Employer Health Care Alliance Cooperative $1,920 788%
Dean Health Plan $1,957 803%
Group Health Cooperative Of Eau Claire $1,957 803%
Oan Llc $1,957 803%
Security Health Plan $2,030 833%
Health Payment Systems $2,070 849%
Praire States $2,079 853%
Quartz Health Insurance $2,079 853%
Sheboygan Employer'S Health Network $2,079 853%
Mayo Clinic Health Solutions $2,128 873%
Aetna $2,153 - $2,177 883%
Bellin Thedacare $2,202 903%
Cigna $2,202 903%
Group Health Cooperative Of South Central Wisconsin $2,202 903%
Prevea Health Network $2,202 903%
Multiplan $2,226 - $2,324 913%
Coventry Health Care $2,324 953%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens