CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Francis Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,697
Cash Discount Price: $1,433
vs. Medicare Baseline: 6.96x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Francis Hospital is $1,697. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,433. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.96x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$1,433

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,697

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: $1,433 (588%)

Insurance Median: $1,697 (696%)

Cash: $1,433 (588% of Medicare)

Ins. Median: $1,697 (696% 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 696% of the Medicare baseline (a markup of 596%). 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
Wexford	$209	86%
Molina Healthcare	$219 - $1,990	90%
Meridian Health Plan	$230	94%
Blue Cross Blue Shield	$418 - $1,990	171%
Humana	$418 - $1,990	171%
Clear Spring Health of Illinois	$418 - $1,990	171%
UnitedHealthcare	$438 - $1,990	180%
Aetna	$438 - $1,990	180%
Amish Community	$557	228%
Celtic Insurance Company	$1,007 - $4,378	413%
Claim Doc	$1,045 - $4,975	429%
Hopetrust	$1,144 - $4,975	469%
Wellfirst	$1,280	525%
First Health	$1,477	606%
Caterpillar, Inc.	$1,596	655%
Current Health Solutions	$1,672	686%
Consociate Group	$1,692	694%
Multiplan/Phcs	$1,692	694%
Healthlink	$1,697	696%
Cigna	$1,771	727%
Healthcare Finest Network (Hfn)	$1,791	735%
Provider Network of America	$1,791	735%
Naphcare	$1,990	816%
Live360	$1,990	816%
Interplan	$1,990	816%
Health Alliance Medical Plans	$1,990	816%
Healthscope	$1,990	816%
Illinois Breast and Cervical Cancer Program	$1,990	816%

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 $1,433.
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 St Francis 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.