CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Lukes Regional Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $227
Cash Discount Price: $384
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Lukes Regional Medical Center is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $384. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.93x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.

Cash / Self-Pay

$384

Average discount available for prompt cash payment at this facility.

Insurance Median

$227

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: $384 (158%)

Insurance Median: $227 (93%)

Cash: $384 (158% of Medicare)

Ins. Median: $227 (93% 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
Nebraska Total Care	$25 - $135	10%
Aetna	$30 - $591	12%
Blue Cross Blue Shield	$30 - $401	12%
Molina	$30 - $240	12%
Amerivantage	$31 - $247	13%
Humana	$31 - $247	13%
UnitedHealthcare	$31 - $645	13%
Avera Health Plan	$44 - $312	18%
Wellmark Uph Self-Funded	$59 - $341	24%
Health Partners Open Network	$63 - $399	26%
Cigna	$78 - $438	32%
Amerigroup	$214	88%
Iowa Total Care	$214	88%
Medica Exchange Inspire	$248	102%
Medica Exchange Insure	$277	114%

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 $384.
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 St Lukes 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.