CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Sheridan Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $931
Cash Discount Price: $539
vs. Medicare Baseline: 3.82x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Sheridan Memorial Hospital is $931. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $539. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.82x the Medicare baseline. Located in 1401 W 5Th St, Sheridan, WY.

Cash / Self-Pay

$539

Average discount available for prompt cash payment at this facility.

Insurance Median

$931

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: $539 (221%)

Insurance Median: $931 (382%)

Cash: $539 (221% of Medicare)

Ins. Median: $931 (382% 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 382% of the Medicare baseline (a markup of 282%). 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
Humana	$32 - $261	13%
Blue Cross Blue Shield	$80 - $913	33%
Pacificsource-All Plans	$218 - $968	89%
Wise Provider Network-All Plans	$218 - $1,023	89%
Medi-Share Profee Only - All Plans	$223	91%
Miscellaneous-All Plans	$223 - $990	91%
Cigna	$231 - $1,023	95%
First Choice Comm - All Plans	$236 - $1,045	97%
Phcs Multiplan-All Plans	$236 - $1,045	97%
Three Rivers-All Plans	$236 - $1,045	97%
Wy School Boards-All Plans	$918	377%
UnitedHealthcare	$943	387%
C1 Employee - All Plans	$990	406%
Casper Opco Llc - All Plans	$990	406%
First Health Comm - All Plans	$990	406%
Ebms - All Plans	$1,045	429%

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 $539.
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 Sheridan 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.