CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Spencer Municipal Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,018
  • Cash Discount Price: $898
  • vs. Medicare Baseline: 4.18x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Spencer Municipal Hospital is $1,018. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $898. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.18x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.
Cash / Self-Pay
$898

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,018

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: $898 (368%)
Insurance Median: $1,018 (418%)
Cash: $898 (368% of Medicare)
Ins. Median: $1,018 (418% 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 418% of the Medicare baseline (a markup of 318%). 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
Medicare (plans) $203 - $205 83%
UnitedHealthcare $203 - $1,077 83%
Humana $205 - $1,137 84%
Medicaid / KanCare $228 94%
Wellmark Hmo $383 157%
Wellmark Ppo $420 172%
Healthpartners (All) $958 393%
Midlands Choice - Ilcc $1,018 418%
Midlands Choice - Morton Bldg $1,018 418%
Coventry - Commercial Hmo $1,077 442%
Avera Health Plan $1,137 466%
Coventry - Commercial Ppo $1,137 466%
First Choice Of Midwest $1,137 466%
Midlands Choice (All Others) $1,137 466%
Sanford Health $1,137 466%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 1St Avenue East, Spencer, IA 51301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals