CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mercyone Oelwein Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,396
  • Cash Discount Price: $987
  • vs. Medicare Baseline: 5.73x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercyone Oelwein Medical Center is $1,396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $987. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.73x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$987

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,396

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: $987 (405%)
Insurance Median: $1,396 (573%)
Cash: $987 (405% of Medicare)
Ins. Median: $1,396 (573% 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 573% of the Medicare baseline (a markup of 473%). 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) $581 - $647 238%
Iowa Total Care $589 242%
Medicaid / KanCare $597 - $600 245%
Blue Cross Blue Shield $616 253%
UnitedHealthcare $660 - $1,311 271%
Aetna $716 - $1,396 294%
Amish Hospital Aid $828 340%
Centivo $934 383%
Ambetter / Centene $1,046 429%
Health Choices $1,118 459%
Medical Associates $1,118 459%
Claimdoc $1,252 514%
Nova $1,252 514%
Geha $1,311 538%
1199 National Benefit Fund $1,396 573%
Allied Benefit Systems $1,396 573%
Asr Health Benefits $1,396 573%
Christian Brother Services $1,396 573%
Coventry $1,396 573%
First Health $1,396 573%
Lucent Health $1,396 573%
Luminare Health $1,396 573%
Medical Mutual $1,396 573%
Meritain $1,396 573%
Trustmark Small Business Benefits $1,396 573%
Webtpa $1,396 573%
Health Partners $1,461 599%
Multiplan $1,473 604%
Auxiant $1,489 611%
Cigna $1,489 611%
Medica $1,489 611%
Midlands $1,489 611%
Midlands Choice $1,489 611%
Crime Victim Assistance $1,519 623%
Iowa Dept Of Public Health $1,519 623%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Eighth Avenue Se, Oelwein, IA 50662
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals