CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Southeast Iowa Regional Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $320
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Southeast Iowa Regional Medical Center is $320. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.31x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$320

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%)

Insurance Median: $320 (131%)

Ins. Median: $320 (131% 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.

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
American Healthplan Of Iowa - Midlevel	$25 - $142	10%
Medicaid / KanCare	$30 - $179	12%
Humana	$31 - $175	13%
American Healthplan Of Iowa - Md	$33 - $186	14%
Aetna	$44 - $249	18%
Blue Cross Blue Shield	$59 - $417	24%
Midlands Choice	$76 - $863	31%
UnitedHealthcare	$78 - $437	32%
Immergrun	$154	63%
6 Degree	$195 - $767	80%
Plain Church	$231 - $623	95%
Absolute Solutions	$320 - $472	131%
First Agency	$320 - $472	131%
Multiplan	$320 - $472	131%
Henderson County	$338 - $499	139%
Elap	$357 - $510	146%
Wellpoint (Amerigroup)	$537	220%
Immugrun	$604	248%
Brighton Amish Church	$623	256%
Geha	$892	366%

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 $X.
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 Southeast Iowa Regional Medical Center 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.