CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Methodist Jennie Edmundson

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $488
Cash Discount Price: $345
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Methodist Jennie Edmundson is $488. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.00x the Medicare baseline. Located in 933 East Pierce Street, Council Bluffs, IA.

Cash / Self-Pay

$345

Average discount available for prompt cash payment at this facility.

Insurance Median

$488

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: $345 (142%)

Insurance Median: $488 (200%)

Cash: $345 (142% of Medicare)

Ins. Median: $488 (200% 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 200% of the Medicare baseline (a markup of 100%). 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
Medicare (plans)	$169 - $574	69%
Aetna	$240 - $689	98%
Humana	$240	98%
Blue Cross Blue Shield	$244 - $747	100%
Medica	$244 - $517	100%
UnitedHealthcare	$244 - $1,871	100%
Elite Choice - Mje	$323 - $498	133%
Wellmark	$327 - $359	134%
Ambetter / Centene	$352 - $505	144%
Midlands Choice	$431 - $804	177%
Ne Furniture Mart	$529 - $689	217%
Medica Choice	$574	235%

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 $345.
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 Methodist Jennie Edmundson 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.