CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Luke's Wood River Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,264
Cash Discount Price: $1,628
vs. Medicare Baseline: 5.19x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Luke's Wood River Medical Center is $1,264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,628. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.19x the Medicare baseline. Located in 100 Hospital Drive, Ketchum, ID.

Cash / Self-Pay

$1,628

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,264

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: $1,628 (668%)

Insurance Median: $1,264 (519%)

Cash: $1,628 (668% of Medicare)

Ins. Median: $1,264 (519% 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 519% of the Medicare baseline (a markup of 419%). 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
Commercial [1028]	$743 - $2,106	305%
Medicare (plans)	$743 - $1,262	305%
Veterans Affairs [1056]	$743 - $1,237	305%
Blue Cross Blue Shield	$750 - $1,856	308%
UnitedHealthcare	$780 - $1,965	320%
Aetna	$817 - $2,062	335%
Moda [1055]	$1,147 - $1,910	471%
Geha [1065]	$1,179 - $1,965	484%
United Medical Resources [1051]	$1,179 - $1,965	484%
Cigna	$1,212 - $2,019	497%
Providence [1022]	$1,212 - $2,019	497%
Pacificsource [1020]	$1,225 - $2,041	503%
First Health [1064]	$1,238 - $2,106	508%
Webtpa [1071]	$1,238 - $2,062	508%

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 $1,628.
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 St Luke's Wood River 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.