CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Boone County Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $722
Cash Discount Price: $1,283
vs. Medicare Baseline: 2.96x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Boone County Hospital is $722. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,283. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.96x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$1,283

Average discount available for prompt cash payment at this facility.

Insurance Median

$722

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: $1,283 (526%)

Insurance Median: $722 (296%)

Cash: $1,283 (526% of Medicare)

Ins. Median: $722 (296% 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 296% of the Medicare baseline (a markup of 196%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Tricare	$244	100%
Wellmark Hmo	$296	121%
Wellmark Ppo - All Other Plans	$326	134%
Choice Care Mcr Adv - All Plans	$658	270%
Humana	$658 - $1,444	270%
Iowa Hlth Adv - All Plans	$658	270%
Mt Carmel Hp - All Plans	$658	270%
UnitedHealthcare	$658 - $942	270%
Va Ccn-All Plans	$658	270%
Amerigroup Mcr Adv - All Other Plans	$664	272%
Aetna	$673 - $1,251	276%
Meridian Mcaid - All Plans	$722	296%
Iowa Total Care Mcaid - All Plans	$736	302%
Medicaid / KanCare	$744	305%
Healthsmart Accell Network	$1,123	461%
Medical Associates Hp-All Plans	$1,203	493%
Healthsmart Ppo - All Other Plans	$1,283	526%
Health Alliance-All Plans	$1,444	592%
Midlands Choice-All Plans	$1,476	605%
Mutually Preferred-All Plans	$1,524	625%

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 $1,283.
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 Boone County Hospital 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.