CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mercy Hospital Joplin

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $794
  • Cash Discount Price: $1,201
  • vs. Medicare Baseline: 3.26x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercy Hospital Joplin is $794. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,201. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.26x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$1,201

Average discount available for prompt cash payment at this facility.

Insurance Median
$794

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: $1,201 (493%)
Insurance Median: $794 (326%)
Cash: $1,201 (493% of Medicare)
Ins. Median: $794 (326% 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 326% of the Medicare baseline (a markup of 226%). 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 $42 - $517 17%
Blue Cross Blue Shield $79 - $1,346 32%
Indian Health Service Contracted [320198] $125 - $1,201 51%
Aetna $158 - $1,145 65%
Humana $158 - $554 65%
Champva [20065] $215 88%
Cherokee Nation Health Serv Contracted [320066] $215 88%
Cigna $215 - $935 88%
Cross Timbers Hospice [20098] $215 88%
Dept Of Veteran Affairs Contracted [320106] $215 88%
Elara Caring Aspire Hospice [20433] $215 88%
Globalhealth Contracted [320145] $215 88%
Halo Hcr Inc Hospice Contracted [320432] $215 88%
Halo Hcr Inc Hospice [20432] $215 88%
Kindful Hospice Contracted [320434] $215 88%
Kindful Hospice [20434] $215 88%
Medicare (plans) $215 - $226 88%
Mercy Hospice Okc [20252] $215 88%
Mercy Mgd Behavioral Health Contracted [320259] $215 88%
Pace Of The Ozarks Contracted [320518] $215 88%
Provider Partners Health Plans Contracted [320450] $215 88%
Qual Choice Contracted [320325] $215 88%
Tricare $215 88%
UnitedHealthcare $215 - $757 88%
Centivo Contracted [320505] $219 90%
Healthscope Contracted [320182] $274 112%
Health Choice Contracted [320166] $411 169%
Providrs Care Network Contracted [320484] $447 183%
Ambetter / Centene $517 212%
Home State Health Plan Contracted [320187] $517 212%
Novasys Contracted [320285] $517 212%
Point C Contracted [320238] $646 - $1,478 265%
Medica Contracted [320239] $672 276%
United Medical Resources Contracted [320454] $757 - $1,219 311%
Benefit Management Contracted [320052] $794 326%
Health Systems Inc Contracted [320174] $794 326%
Insurance System Inc Contracted [320465] $794 326%
Administrative Payor Contracted [320005] $831 341%
Mercy Benefit Admin Contracted [320251] $924 - $1,108 379%
Aither Health Contracted [320449] $1,053 432%
Auxiant Contracted [320462] $1,053 - $1,201 432%
Ebms Contracted [320493] $1,053 432%
Edison Health Solutions Contracted [320502] $1,053 432%
Healthlink Contracted [320179] $1,053 - $1,478 432%
Imagine 360 Contracted [320494] $1,053 432%
Reflect Health Contracted [320492] $1,053 432%
Yuzu Health Contracted [320521] $1,053 432%
90 Degree Benefits Contracted [320436] $1,108 455%
Show-Me Health Administrators Contracted [320483] $1,108 455%
Preferred Health Plan Contracted [320522] $1,201 493%
First Health Contracted [320128] $1,258 516%
American Healthcare Alliance Contracted [320020] $1,293 530%
Multiplan Contracted [320270] $1,422 583%
Private Health Care Systems Contracted [320320] $1,422 583%
Usable Contracted [320409] $1,422 583%
Point C [20238] $1,478 606%
Workers Comp [20426] $1,478 - $1,847 606%
Usa Managed Care Org Contracted [320429] $1,625 667%
Ppo Plus Contracted [320310] $1,662 682%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Mercy Way, Joplin, MO 64804
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals