CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mercyone North Iowa Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $513
  • Cash Discount Price: $1,303
  • vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercyone North Iowa Medical Center is $513. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,303. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.10x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$1,303

Average discount available for prompt cash payment at this facility.

Insurance Median
$513

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: $1,303 (535%)
Insurance Median: $513 (210%)
Cash: $1,303 (535% of Medicare)
Ins. Median: $513 (210% 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 210% of the Medicare baseline (a markup of 110%). 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
Iowa Total Care $231 95%
Medicaid / KanCare $233 - $234 96%
Bcn Domestic $244 100%
Blue Benefit Administrators Of Massachusetts $244 100%
Blue Care Network $244 100%
Blue Cross Blue Shield $244 - $255 100%
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%
Kaiser Domestic $244 100%
Pre-Employment $244 100%
Wc Domestic $244 100%
Aetna $252 - $1,052 103%
Medicare (plans) $252 - $262 103%
UnitedHealthcare $257 - $2,004 105%
Centivo $316 130%
Oscar $339 139%
Amish Hospital Aid $342 140%
Ambetter / Centene $432 177%
Health Choices $513 210%
Medical Associates $513 210%
Claimdoc $517 212%
Nova $517 212%
Geha $699 287%
1199 National Benefit Fund $1,052 432%
Allied Benefit Systems $1,052 432%
Asr Health Benefits $1,052 432%
Christian Brother Services $1,052 432%
Coventry $1,052 432%
First Health $1,052 432%
Lucent Health $1,052 432%
Luminare Health $1,052 432%
Medical Mutual $1,052 432%
Meritain $1,052 432%
Trustmark Small Business Benefits $1,052 432%
Webtpa $1,052 432%
Preferred One $1,303 535%
Health Partners $1,341 550%
Auxiant $1,403 576%
Cigna $1,403 576%
Medica $1,403 576%
Midlands $1,403 576%
Midlands Choice $1,403 576%
Mhnet $1,603 658%
Multiplan $1,804 740%
Crime Victim Assistance $2,004 822%
Iowa Dept Of Public Health $2,004 822%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Fourth Street Sw, Mason City, IA 50401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals