CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Perry County Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $921
  • Cash Discount Price: $1,097
  • vs. Medicare Baseline: 3.78x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Perry County Memorial Hospital is $921. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,097. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.78x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.
Cash / Self-Pay
$1,097

Average discount available for prompt cash payment at this facility.

Insurance Median
$921

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: $1,097 (450%)
Insurance Median: $921 (378%)
Cash: $1,097 (450% of Medicare)
Ins. Median: $921 (378% 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 378% of the Medicare baseline (a markup of 278%). 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
Medicaid / KanCare $360 - $1,567 148%
Veterans Administration $392 - $1,567 161%
Bc 130 $407 - $1,252 167%
Group Insurance $407 - $1,567 167%
Medicare (plans) $407 167%
Workers Compensation $784 322%
Nsa $921 - $967 378%
Guarantor Liable $1,097 - $1,567 450%
Pcmh Insurnace $1,222 - $1,567 501%
Secondary Insurance $1,252 514%
UnitedHealthcare $1,252 514%
Operating Engineers $1,332 546%
Boilermakers Healthcare $1,363 559%
Cigna $1,363 559%
Great West $1,363 - $1,567 559%
Sagxxxx $1,363 559%
Champus $1,567 643%
Ngs American, Inc $1,567 643%
Patoka Valley $1,567 643%
Southwire $1,567 643%
Tricare $1,567 643%
Wausau Benefits $1,567 643%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8885 Sr 237, Tell City, IN 47586
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals