CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $591
  • Cash Discount Price: $880
  • vs. Medicare Baseline: 2.42x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Essentia Health St Joseph's Medical Center is $591. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $880. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.42x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$880

Average discount available for prompt cash payment at this facility.

Insurance Median
$591

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: $880 (361%)
Insurance Median: $591 (242%)
Cash: $880 (361% of Medicare)
Ins. Median: $591 (242% 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 242% of the Medicare baseline (a markup of 142%). 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
Primewest $236 97%
Itasca Med Care $242 99%
Advocare/Security Health $260 107%
Blue Cross Blue Shield $260 - $916 107%
Freedom Blue Ppo $260 107%
Healthpartners Care Msho / Mcr Adv $260 107%
Imcare Msho Pcc Prime $260 107%
Imcare Msho Ref Req $260 107%
Medica Advantage Solutions $260 107%
Medica Msho/Dual Solutions $260 107%
Medica Prime Solution Group $260 107%
Medicare (plans) $260 107%
Nd Va Administration $260 107%
Platinum Blue/Vantage Blue $260 107%
Primewest Msho $260 107%
Secure Blue Msho $260 107%
Ubh Cost Plan $260 107%
Ubh Msho $260 107%
Ucare Msho $260 107%
UnitedHealthcare $260 - $995 107%
Medica Access $413 169%
Sanford Health Plan $561 - $591 230%
Healthpartners Care Pmap $562 231%
Blue Plus Pmap Pcc Prime $589 - $885 242%
Medica $832 - $925 341%
Medica Uplan $832 341%
Ucare $861 353%
Wea $942 - $1,007 386%
Medica Choice $952 391%
Cigna $961 394%
Healthpartners $961 394%
Healthpartners Pcc Prime $961 394%
America'S Ppo $1,014 416%
Wps $1,086 - $1,099 446%
Aetna $1,112 456%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals