CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Vandalia Health Broaddus Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $542
  • Cash Discount Price: $464
  • vs. Medicare Baseline: 2.22x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Vandalia Health Broaddus Hospital is $542. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $464. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.22x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.
Cash / Self-Pay
$464

Average discount available for prompt cash payment at this facility.

Insurance Median
$542

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: $464 (190%)
Insurance Median: $542 (222%)
Cash: $464 (190% of Medicare)
Ins. Median: $542 (222% 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 222% of the Medicare baseline (a markup of 122%). 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
Correctional Medical Systems $24 - $122 10%
Aetna $25 - $631 10%
The Health Plan $25 - $635 10%
Unicare $25 - $128 10%
Blue Cross Blue Shield $60 - $501 25%
Peak Health $107 - $225 44%
Highmark $453 - $517 186%
UnitedHealthcare $458 - $686 188%
Humana $476 - $543 195%
West Virginia Senior Advantage $481 - $549 197%
Cigna $542 - $618 222%
First Health $553 - $631 227%
Geisenger Health Plan $576 - $657 236%
Health Network America $576 - $671 236%
Multiplan/Phcs $582 - $664 239%
Geha $588 - $671 241%
Selectnet $607 - $692 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Healthcare Drive Mansfield Hill, Philippi, WV 26416
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals