CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mercyone Newton Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $725
  • Cash Discount Price: $987
  • vs. Medicare Baseline: 2.97x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercyone Newton Medical Center is $725. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $987. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.97x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$987

Average discount available for prompt cash payment at this facility.

Insurance Median
$725

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: $987 (405%)
Insurance Median: $725 (297%)
Cash: $987 (405% of Medicare)
Ins. Median: $725 (297% 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 297% of the Medicare baseline (a markup of 197%). 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
Aetna $226 - $1,495 93%
Medicare (plans) $226 - $235 93%
Blue Cross Blue Shield $228 - $244 94%
UnitedHealthcare $230 - $1,097 94%
Blue Benefit Administrators Of Massachusetts $244 100%
Blue Care Network $244 100%
Blue Distinction Transplant $244 100%
Blue Shield - Ca $244 100%
Blue Shield - Id (Regence) $244 100%
Blue Shield - Ny Highmark Northeastern $244 100%
Blue Shield - Ny Highmark Western $244 100%
Blue Shield - Pa (Highmark) $244 100%
Blue Shield - Wa (Regence) $244 100%
Iowa Total Care $275 113%
Medicaid / KanCare $278 - $279 114%
Amish Hospital Aid $307 126%
Oscar $327 134%
Centivo $333 137%
Ambetter / Centene $387 159%
Claimdoc $463 190%
Nova $463 190%
Newton Correctional Facility $987 405%
Geha $1,097 450%
Health Choices $1,147 471%
Medical Associates $1,147 471%
Health Partners $1,340 550%
Auxiant $1,397 573%
Cigna $1,397 573%
Health Alliance $1,397 573%
Medica $1,397 573%
Midlands $1,397 573%
Midlands Choice $1,397 573%
1199 National Benefit Fund $1,495 613%
Allied Benefit Systems $1,495 613%
Asr Health Benefits $1,495 613%
Christian Brother Services $1,495 613%
Coventry $1,495 613%
First Health $1,495 613%
Lucent Health $1,495 613%
Luminare Health $1,495 613%
Medical Mutual $1,495 613%
Meritain $1,495 613%
Trustmark Small Business Benefits $1,495 613%
Webtpa $1,495 613%
Crime Victim Assistance $1,519 623%
Iowa Dept Of Public Health $1,519 623%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals