CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Eastern Idaho Regional Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,053
Cash Discount Price: $1,946
vs. Medicare Baseline: 4.32x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Eastern Idaho Regional Medical Center is $1,053. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,946. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.32x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.

Cash / Self-Pay

$1,946

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,053

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: $1,946 (798%)

Insurance Median: $1,053 (432%)

Cash: $1,946 (798% of Medicare)

Ins. Median: $1,053 (432% 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 432% of the Medicare baseline (a markup of 332%). 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
Blue Cross Blue Shield	$26 - $2,299	11%
Molina	$26 - $141	11%
Interwest Health	$343 - $2,178	141%
Select Health	$446 - $733	183%
Select Health Ichn Brightpath	$446 - $818	183%
Select Health Idaho (Eirmc Only)	$470 - $772	193%
Aetna	$580 - $1,179	238%
Doug Andrus Distributing	$589 - $968	242%
Pacificsource Health	$618 - $1,297	254%
University Of Utah	$618 - $1,017	254%
Regence	$639	262%
Mountain Health Co-Op	$736 - $1,815	302%
Cigna	$810 - $1,331	332%
United	$851 - $1,399	349%
First Choice Health Of Washington	$883 - $1,452	362%
Moda	$917 - $1,508	376%
Dmba	$948 - $1,559	389%
Prime Health	$1,104 - $2,057	453%
Geha Ppo Usa	$1,178 - $1,936	483%
Humana	$1,237 - $2,033	507%
Multiplan	$1,237 - $2,178	507%
First Choice Of The Midwest	$1,325 - $2,178	544%
St. John'S Health Network	$1,325 - $2,178	544%
Coventry First Health	$1,340 - $2,203	550%
Shashone-Bannock Tribal Health	$1,472 - $2,420	604%

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 $1,946.
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 Eastern Idaho 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.