CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Essentia Health Virginia

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $833
  • Cash Discount Price: $821
  • vs. Medicare Baseline: 3.42x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Essentia Health Virginia is $833. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $821. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.42x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.
Cash / Self-Pay
$821

Average discount available for prompt cash payment at this facility.

Insurance Median
$833

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: $821 (337%)
Insurance Median: $833 (342%)
Cash: $821 (337% of Medicare)
Ins. Median: $833 (342% 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 342% of the Medicare baseline (a markup of 242%). 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%
Advocare/Security Health $237 97%
Blue Cross Blue Shield $237 - $1,112 97%
Freedom Blue Ppo $237 97%
Healthpartners Care Msho / Mcr Adv $237 97%
Imcare Msho Pcc Prime $237 97%
Imcare Msho Ref Req $237 97%
Medica Advantage Solutions $237 97%
Medica Msho/Dual Solutions $237 97%
Medica Prime Solution Group $237 97%
Medicare (plans) $237 97%
Nd Va Administration $237 97%
Platinum Blue/Vantage Blue $237 97%
Primewest Msho $237 97%
Secure Blue Msho $237 97%
Ubh Cost Plan $237 97%
Ubh Msho $237 97%
Ucare Msho $237 97%
UnitedHealthcare $237 - $1,151 97%
Itasca Med Care $242 99%
Medica Access $301 123%
Sanford Healthplan $428 - $591 176%
Healthpartners Care Pmap $521 214%
Blue Plus Pmap Pcc Prime $614 - $878 252%
Medica $833 - $926 342%
Medica Uplan $833 342%
Ucare $861 353%
Healthpartners $934 - $1,182 383%
Wea $942 - $1,007 386%
Medica Choice $954 391%
Security Health $1,007 413%
America'S Ppo $1,014 416%
Wps $1,086 - $1,099 446%
Aetna $1,112 456%
Cigna $1,179 - $1,182 484%
Healthpartners Pcc Prime $1,179 - $1,182 484%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 9Th Street North, Virginia, MN 55792
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals