CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Lost Rivers Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $775
  • Cash Discount Price: $960
  • vs. Medicare Baseline: 3.18x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Lost Rivers Medical Center is $775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $960. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.18x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.
Cash / Self-Pay
$960

Average discount available for prompt cash payment at this facility.

Insurance Median
$775

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: $960 (394%)
Insurance Median: $775 (318%)
Cash: $960 (394% of Medicare)
Ins. Median: $775 (318% 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 318% of the Medicare baseline (a markup of 218%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Provider Network Of America-All Plans $439 180%
Select Health Brightpath-All Other Plans $680 279%
Tricare $680 279%
Ihcn Brightpath-All Other Plans $718 295%
Va Pccc-All Plans $733 301%
Blue Cross Blue Shield $756 - $1,200 310%
Humana $756 - $1,200 310%
Ihcn Brightpath Mcr Adv $756 310%
Molina Mcr Adv-All Plans $756 310%
Pacificsource Mcr Adv $756 310%
Regence/Brightpth Slhp Mcr $756 310%
Select Health Mcr Adv $756 310%
Prime Hlth Mcr Adv $794 326%
Aetna $816 - $1,128 335%
Cigna $1,116 458%
First Choice-All Plans $1,116 458%
Pacificsource Navigator-All Other Plans $1,140 468%
UnitedHealthcare $1,140 468%
Altius Health Plan-All Plans $1,164 477%
Regence Blue Shield-All Other Plans $1,176 482%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 551 Highland Drive, Arco, ID 83213
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals