CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Essentia Health Ada

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $861
  • Cash Discount Price: $967
  • vs. Medicare Baseline: 3.53x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Essentia Health Ada is $861. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $967. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.53x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.
Cash / Self-Pay
$967

Average discount available for prompt cash payment at this facility.

Insurance Median
$861

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: $967 (397%)
Insurance Median: $861 (353%)
Cash: $967 (397% of Medicare)
Ins. Median: $861 (353% 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 353% of the Medicare baseline (a markup of 253%). 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%
Healthpartners Care Pmap $509 209%
Medica Access $521 - $815 214%
Sanford Health Plan $561 - $591 230%
Advocare/Security Health $628 258%
Blue Cross Blue Shield $628 - $1,140 258%
Freedom Blue Ppo $628 258%
Healthpartners Care Msho / Mcr Adv $628 258%
Imcare Msho Pcc Prime $628 258%
Imcare Msho Ref Req $628 258%
Medica Advantage Solutions $628 258%
Medica Msho/Dual Solutions $628 258%
Medica Prime Solution Group $628 258%
Medicare (plans) $628 258%
Nd Va Administration $628 258%
Platinum Blue/Vantage Blue $628 258%
Primewest Msho $628 258%
Secure Blue Msho $628 258%
Ubh Cost Plan $628 258%
Ubh Msho $628 258%
Ucare Msho $628 258%
UnitedHealthcare $628 - $1,184 258%
Blue Plus Pmap Pcc Prime $719 - $1,140 295%
Healthpartners $795 - $870 326%
Ucare $861 353%
Cigna $870 357%
Healthpartners Pcc Prime $870 357%
Wea $942 - $1,007 386%
America'S Ppo $1,014 416%
Wps $1,086 - $1,099 446%
Medica $1,087 - $1,144 446%
Medica Uplan $1,087 446%
Aetna $1,112 456%
Medica Choice $1,179 484%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 9Th Street West, Ada, MN 56510
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals