CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mercyone Clinton Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $469
  • Cash Discount Price: $863
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercyone Clinton Medical Center is $469. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $863. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.92x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$863

Average discount available for prompt cash payment at this facility.

Insurance Median
$469

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: $863 (354%)
Insurance Median: $469 (192%)
Cash: $863 (354% of Medicare)
Ins. Median: $469 (192% 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.

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 $220 90%
Medicaid / KanCare $222 - $223 91%
Bcn Domestic $244 100%
Blue Benefit Administrators Of Massachusetts $244 100%
Blue Care Network $244 100%
Blue Cross Blue Shield $244 - $251 100%
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 $249 - $1,161 102%
Medicare (plans) $249 - $259 102%
UnitedHealthcare $254 - $1,327 104%
Amish Hospital Aid $338 139%
Oscar $347 142%
Health Choices $376 154%
Medical Associates $376 154%
Preferred Health Choice $384 158%
Ambetter / Centene $427 175%
Claimdoc $511 210%
Nova $511 210%
Geha $595 244%
The Alliance $805 330%
1199 National Benefit Fund $1,161 476%
Allied Benefit Systems $1,161 476%
Asr Health Benefits $1,161 476%
Christian Brother Services $1,161 476%
Coventry $1,161 476%
First Health $1,161 476%
Lucent Health $1,161 476%
Luminare Health $1,161 476%
Medical Mutual $1,161 476%
Meritain $1,161 476%
Trustmark Small Business Benefits $1,161 476%
Webtpa $1,161 476%
Health Partners $1,164 477%
Auxiant $1,194 490%
Cigna $1,194 490%
Medica $1,194 490%
Midlands $1,194 490%
Midlands Choice $1,194 490%
Multiplan $1,194 490%
Qualcare $1,194 490%
Usa Managed Care $1,261 517%
Crime Victim Assistance $1,327 544%
Iowa Dept Of Public Health $1,327 544%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals