CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Knoxville Hospital & Clinics

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $423
Cash Discount Price: $558
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Knoxville Hospital & Clinics is $423. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $558. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.74x the Medicare baseline. Located in 1002 South Lincoln Street, Knoxville, IA.

Cash / Self-Pay

$558

Average discount available for prompt cash payment at this facility.

Insurance Median

$423

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: $558 (229%)

Insurance Median: $423 (174%)

Cash: $558 (229% of Medicare)

Ins. Median: $423 (174% 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
Wellmark Hmo 7/1/22	$384	158%
Molina Mcaid/Chip - All Plans	$395	162%
Amerigroup Mcaid	$400	164%
Iowa Total Care Mcaid - All Plans	$400	164%
Aetna	$409	168%
Humana	$409 - $790	168%
UnitedHealthcare	$409 - $859	168%
Amerigroup Mcr - All Other Plans	$413	169%
Wellmark Ppo 7/1/22-All Other Plans	$423	174%
Oscar-All Plans	$614	252%
Health Partners New Bus	$651	267%
Medical Associates Health Plan-All Other Plans	$698	286%
Cigna	$902	370%
Health Partners-All Other Plans	$902	370%
Medica Op And Profee Only-All Plans	$902	370%
Midlands Choice-All Plans	$902	370%

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 $558.
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 Knoxville Hospital & Clinics 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.