CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,018
Cash Discount Price: $658
vs. Medicare Baseline: 4.18x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Childrens Hospital of Wisconsin Fox Valley is $1,018. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $658. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.18x the Medicare baseline. Located in 130 Second St, Neenah, WI.

Cash / Self-Pay

$658

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,018

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: $658 (270%)

Insurance Median: $1,018 (418%)

Cash: $658 (270% of Medicare)

Ins. Median: $1,018 (418% 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 418% of the Medicare baseline (a markup of 318%). 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
Froedtert Health	$838 - $1,018	344%
Medical College Of Wisconsin	$838	344%
Network Health Plan	$852	350%
UnitedHealthcare	$880	361%
Aspirus Health Plan	$898	368%
Common Ground Healthcare Cooperative	$898 - $1,018	368%
Trilogy Health Solutions	$898 - $1,018	368%
Wps Health Plan	$910 - $1,078	373%
Advocate Aurora Healthcare	$922	378%
Blue Cross Blue Shield	$934 - $1,137	383%
Centivo	$934	383%
Health Partners	$934 - $1,054	383%
Employer Health Care Alliance Cooperative	$940	386%
Dean Health Plan	$958	393%
Group Health Cooperative Of Eau Claire	$958	393%
Oan Llc	$958	393%
Security Health Plan	$994	408%
Health Payment Systems	$1,013	416%
Praire States	$1,018	418%
Quartz Health Insurance	$1,018	418%
Sheboygan Employer'S Health Network	$1,018	418%
America'S Ppo	$1,042	427%
Aetna	$1,054 - $1,066	432%
Bellin Thedacare	$1,078	442%
Cigna	$1,078	442%
Group Health Cooperative Of South Central Wisconsin	$1,078	442%
Healthsmart	$1,078	442%
Prevea Health Network	$1,078	442%
Multiplan	$1,090 - $1,137	447%
Coventry Health Care	$1,137	466%

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 $658.
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 Childrens Hospital of Wisconsin Fox Valley 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.