CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mon Health Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $731
  • Cash Discount Price: $475
  • vs. Medicare Baseline: 3.00x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mon Health Medical Center is $731. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $475. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.00x the Medicare baseline. Located in 1200 Jd Anderson Drive, Morgantown, WV.
Cash / Self-Pay
$475

Average discount available for prompt cash payment at this facility.

Insurance Median
$731

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: $475 (195%)
Insurance Median: $731 (300%)
Cash: $475 (195% of Medicare)
Ins. Median: $731 (300% 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 300% of the Medicare baseline (a markup of 200%). 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
Geha_Plan $28 - $1,842 11%
Acpn_Plan $62 - $1,709 25%
Aetna $69 - $1,519 28%
Blue Cross Blue Shield $69 - $1,138 28%
Health_South_Mountain_View_Plan $69 - $231 28%
Medicare (plans) $69 - $231 28%
Paramount_Elite_Plan $69 - $231 28%
The_Health_Plan_Murray_Energy_Commercial_Aso_Plan $69 - $1,519 28%
Uhc_Onenet_Ppo_Plan $69 - $1,842 28%
Uhc_Options_Ppo_Plan $69 - $1,766 28%
Uhc_Plan $69 - $1,709 28%
Umwa_Plan $69 28%
Unison_Plan $114 - $147 47%
Gateway_Health_Plan $126 - $147 52%
Seven_Corners_Plan $139 - $462 57%
Maryland_Physicians_Care_Plan $158 - $1,329 65%
Zelis_Other_Plan $196 - $412 80%
Humana $231 - $1,709 95%
Uhc_Va_Plan $231 95%
Zelis_Group_Health_Plan $231 - $412 95%
The_Health_Plan_Peia_Plan $241 99%
Upmc__Plan $274 - $1,842 112%
The_Health_Plan_Plan $1,574 - $1,633 646%
Cigna $1,647 - $1,709 676%
Mon_County_Commission_Plan $1,647 - $1,709 676%
Health_Payors_Organization_Plan $1,683 - $1,747 690%
Multiplan_Phcs_Plan $1,738 - $1,804 713%
Mutual_Of_Omaha_Plan $1,738 - $1,804 713%
Three_Rivers_Plan $1,775 - $1,842 728%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Jd Anderson Drive, Morgantown, WV 26505
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals