CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Preston Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,111
Cash Discount Price: $762
vs. Medicare Baseline: 4.56x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Preston Memorial Hospital is $1,111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $762. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.56x the Medicare baseline. Located in 150 Memorial Drive, Kingwood, WV.

Cash / Self-Pay

$762

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,111

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: $762 (313%)

Insurance Median: $1,111 (456%)

Cash: $762 (313% of Medicare)

Ins. Median: $1,111 (456% 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 456% of the Medicare baseline (a markup of 356%). 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
Unicare	$103	42%
Advantra	$914 - $916	375%
Aetna	$914 - $1,374	375%
Humana	$914 - $916	375%
Medicare (plans)	$914 - $1,236	375%
Uhc_Va	$914 - $916	375%
Upmc	$959 - $962	393%
Medicaid / KanCare	$990 - $1,042	406%
Blue_Cross_Highmark_Aca	$1,108 - $1,111	455%
Blue_Cross_Highmark_Pos	$1,229 - $1,232	504%
Blue_Cross_Highmark_Ppo	$1,229 - $1,232	504%
Blue_Cross_Highmark_Traditional	$1,350 - $1,353	554%
UnitedHealthcare	$1,371 - $1,374	562%
Cigna	$1,401 - $1,404	575%
Geha	$1,447 - $1,450	594%
4_Most	$1,477 - $1,481	606%
Health	$1,477 - $1,481	606%

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 $762.
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 Preston Memorial Hospital 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.