CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $447
  • Cash Discount Price: $559
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Anthony Regional Hospital & Nursing Home is $447. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $559. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.83x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.
Cash / Self-Pay
$559

Average discount available for prompt cash payment at this facility.

Insurance Median
$447

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: $559 (229%)
Insurance Median: $447 (183%)
Cash: $559 (229% of Medicare)
Ins. Median: $447 (183% 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.

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
Humana $201 - $1,438 82%
Medica Mcr - All Plans $201 82%
UnitedHealthcare $201 - $1,364 82%
Ia Total Care Mcr $207 85%
Wellpoint Mcaid - All Other Plans $229 94%
Molina Mcaid - All Plans $234 96%
Ia Total Care Comm - All Other Plans $262 107%
Wellmark Hmo $303 124%
Wellmark Ppo-All Other Plans $333 137%
Aetna $447 - $1,523 183%
Va Ccn - All Plans $609 250%
Wellpoint Mcr Adv $609 250%
Ia Total Care Mcaid $694 285%
Midlands Choice - All Plans $1,590 652%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 311 South Clark Street, Carroll, IA 51401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals