CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Caribou Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,132
Cash Discount Price: $834
vs. Medicare Baseline: 4.64x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Caribou Medical Center is $1,132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $834. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.64x the Medicare baseline. Located in 300 South 3Rd West, Soda Springs, ID.

Cash / Self-Pay

$834

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,132

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: $834 (342%)

Insurance Median: $1,132 (464%)

Cash: $834 (342% of Medicare)

Ins. Median: $1,132 (464% 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 464% of the Medicare baseline (a markup of 364%). 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
Humana	$536	220%
Pacific Source Mcr Adv	$536	220%
Regence Blue Shield Mcr	$536	220%
Select Health Mcr Adv	$536	220%
Select Health/Bright Path Mcr Adv	$536	220%
Blue Cross Blue Shield	$542 - $1,168	222%
Aetna	$751 - $1,168	308%
First Choice Health-All Plans	$1,073	440%
Bc Qualified Hp (Qhp)	$1,109	455%
Deseret Healthcare-All Plans	$1,132	464%
Pacific Source-All Other Plans	$1,156	474%
UnitedHealthcare	$1,156	474%
Cigna	$1,168	479%
Montana Health Co-Op-All Plans	$1,168	479%
Regence Blue Shield-All Other Plans	$1,168	479%
Select Health-All Other Plans	$1,168	479%

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 $834.
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 Caribou 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.