CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Mary's Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $508
  • Cash Discount Price: $357
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Mary's Hospital is $508. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $357. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.08x the Medicare baseline. Located in 701 Lewiston St, Cottonwood, ID.
Cash / Self-Pay
$357

Average discount available for prompt cash payment at this facility.

Insurance Median
$508

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: $357 (146%)
Insurance Median: $508 (208%)
Cash: $357 (146% of Medicare)
Ins. Median: $508 (208% 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 208% of the Medicare baseline (a markup of 108%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Nimiipuu Mcr Adv - Allplans $30 - $734 12%
Regence Blue Shield Mcr $30 - $727 12%
Tricare $30 - $727 12%
UnitedHealthcare $30 - $727 12%
Veterans Admin - All Plans $30 - $727 12%
Blue Cross Blue Shield $35 - $851 14%
Medicare (plans) $35 - $727 14%
Aetna $49 - $824 20%
Idaho Phys Network - All Plans $62 - $842 25%
Multiplan - All Plans $62 - $859 25%
Geha - All Plans $63 - $859 26%
First Choice- All Plans $64 - $868 26%
Corizon Correctional - All Plans $183 - $851 75%
Regence Blue Shield - All Other Plans $886 363%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Lewiston St, Cottonwood, ID 83522
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals