CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mercy Hospital St Louis

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $931
  • Cash Discount Price: $1,407
  • vs. Medicare Baseline: 3.82x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercy Hospital St Louis is $931. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,407. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.82x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$1,407

Average discount available for prompt cash payment at this facility.

Insurance Median
$931

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: $1,407 (577%)
Insurance Median: $931 (382%)
Cash: $1,407 (577% of Medicare)
Ins. Median: $931 (382% 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 382% of the Medicare baseline (a markup of 282%). 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
Aetna $141 - $758 58%
Medicaid / KanCare $141 - $585 58%
American Health Advantage Of Mo Mcr [10473] $225 92%
Blue Cross Blue Shield $225 - $1,948 92%
Cherokee Nation Health Serv Contracted [320066] $225 92%
Cross Timbers Hospice [20098] $225 92%
Dept Of Veteran Affairs Contracted [320106] $225 92%
Elara Caring Aspire Hospice Contracted [320433] $225 92%
Elara Caring Aspire Hospice [20433] $225 92%
Globalhealth Contracted [320145] $225 92%
Halo Hcr Inc Hospice Contracted [320432] $225 92%
Halo Hcr Inc Hospice [20432] $225 92%
Humana $225 92%
Kindful Hospice Contracted [320434] $225 92%
Kindful Hospice [20434] $225 92%
Medicare (plans) $225 - $2,165 92%
Mercy Hospice Okc [20252] $225 92%
Pace Of The Ozarks Contracted [320518] $225 92%
Qual Choice Contracted [320325] $225 92%
Tricare $225 92%
UnitedHealthcare $225 - $352 92%
Cigna $229 - $974 94%
Hope Trust Contracted [320488] $229 94%
Provider Partners Health Plans Contracted [320450] $248 102%
Healthscope Contracted [320182] $286 117%
United Medical Resources Contracted [320454] $352 144%
Centivo Contracted [320505] $378 155%
Preferred Health Plan Contracted [320522] $401 164%
Medica Contracted [320239] $565 232%
Ambetter / Centene $585 240%
Home State Health Plan Contracted [320187] $585 240%
Novasys Contracted [320285] $585 240%
Aither Health Contracted [320449] $931 382%
Aither Health [20449] $931 382%
Auxiant Contracted [320462] $931 382%
Ebms Contracted [320493] $931 382%
Edison Health Solutions Contracted [320502] $931 382%
Healthlink Contracted [320179] $931 - $1,472 382%
Imagine 360 Contracted [320494] $931 382%
Mercy Benefit Admin Contracted [320251] $931 - $974 382%
Mercy Benefit Admin [20251] $931 - $974 382%
Reflect Health Contracted [320492] $931 382%
Show-Me Health Administrators Contracted [320483] $931 382%
Yuzu Health Contracted [320521] $931 382%
Health Choices Contracted [320448] $1,299 533%
Health Choices [20448] $1,299 533%
Medical Associates Health Contracted [320444] $1,299 533%
Federal Medical Center Contracted [320127] $1,407 577%
Insurance System Inc Contracted [320465] $1,407 577%
Point C Contracted [320238] $1,407 577%
Tri State Healthcare Coalition Contracted [320379] $1,407 577%
First Health Contracted [320128] $1,516 - $1,537 622%
Mercy Mgd Behavioral Health Contracted [320259] $1,516 622%
Multiplan Contracted [320270] $1,516 - $1,624 622%
Private Health Care Systems Contracted [320320] $1,516 622%
Workers Comp [20426] $1,624 - $1,732 666%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 615 New Ballas Road, Saint Louis, MO 63141
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals