CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Sanford Bemidji Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,092
Cash Discount Price: $1,243
vs. Medicare Baseline: 4.48x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Sanford Bemidji Medical Center is $1,092. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,243. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.48x the Medicare baseline. Located in 1300 Anne St Nw, Bemidji, MN.

Cash / Self-Pay

$1,243

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,092

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: $1,243 (510%)

Insurance Median: $1,092 (448%)

Cash: $1,243 (510% of Medicare)

Ins. Median: $1,092 (448% 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 448% of the Medicare baseline (a markup of 348%). 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
Blue Cross Blue Shield	$177 - $866	73%
Sanford Health Plan Align	$225	92%
Ucare	$242 - $1,092	99%
Aetna	$244 - $1,274	100%
Health Partners	$244 - $1,088	100%
Medicare (plans)	$244	100%
UnitedHealthcare	$244 - $1,298	100%
Primewest	$249 - $266	102%
Sanford Health Plan	$708 - $950	290%
Security Health Plan	$855	351%
Medica	$1,305 - $1,397	535%
Cigna	$1,399	574%
First Choice Health Network	$1,399	574%
Healthez	$1,399	574%
Multiplan	$1,399	574%

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 $1,243.
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 Sanford Bemidji 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.