CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mayers Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $566
  • Cash Discount Price: $596
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mayers Memorial Hospital is $566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $596. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.32x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.
Cash / Self-Pay
$596

Average discount available for prompt cash payment at this facility.

Insurance Median
$566

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: $596 (244%)
Insurance Median: $566 (232%)
Cash: $596 (244% of Medicare)
Ins. Median: $566 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Blue Shield Ca Va $31 - $575 13%
Blue Shield Mcr Adv $31 - $575 13%
Tricare $31 - $605 13%
Health Net Mcr Adv $32 - $605 13%
Arcadian Health Services-All Plans $34 - $605 14%
Imperial Health Plan-All Plans $36 - $684 15%
Cigna $71 - $871 29%
Corvel Ppo-All Plans $71 - $871 29%
Coventry/First Health-All Plans $71 - $871 29%
Integrated Hp-All Plans $71 - $871 29%
Interplan-All Plans $71 - $871 29%
Medi-Cal $75 - $241 31%
Blue Cross Blue Shield $397 - $784 163%
Health Net Prison $429 - $660 176%
Blue Shield Ca Exchange $510 - $784 209%
Blue Shield-All Other Plans $566 - $871 232%
Hmn-All Plans $566 - $871 232%
Multiplan Phcs-All Plans $566 - $871 232%
Pfmc-All Plans $566 - $871 232%
Superior Ca-All Plans $566 - $871 232%
Health Net-All Other Plans $593 - $913 243%
Pacificare-All Plans $596 - $917 244%
Partnership Hp-All Plans $596 - $917 244%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43563 Hwy 299 East, Fall River Mills, CA 96028
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals