CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Northeast Regional Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,614
  • Cash Discount Price: $1,422
  • vs. Medicare Baseline: 6.62x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Northeast Regional Medical Center is $1,614. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,422. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.62x the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.
Cash / Self-Pay
$1,422

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,614

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: $1,422 (583%)
Insurance Median: $1,614 (662%)
Cash: $1,422 (583% of Medicare)
Ins. Median: $1,614 (662% 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 662% of the Medicare baseline (a markup of 562%). 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 $206 - $336 85%
Veterans Eval Services $208 85%
Node Champva $241 99%
Tricare $241 99%
Medicare (plans) $252 103%
Node Hospice Non Par Agree $256 105%
Node Va $256 105%
UnitedHealthcare $256 - $2,752 105%
Blue Cross Blue Shield $257 - $1,119 105%
Node Devoted Health Mcr Adv $264 108%
Blue Pathway/Pathway X $293 120%
Centurion Correctional $320 131%
Us Department Of Labor $320 131%
Home State Exchange $461 189%
Naphcare $486 199%
Immergrun $512 210%
Blue Prefrerred $612 251%
Blue Access $631 259%
Self Pay $857 - $2,018 352%
Cigna $1,214 - $1,435 498%
Aetna $1,328 - $3,060 545%
Access Health Services, Llc $2,321 - $2,385 952%
Healthlink $2,678 - $2,936 1099%
Multiplan $2,678 - $2,936 1099%
Coventry Wc $2,856 - $2,936 1172%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 S Osteopathy, Kirksville, MO 63501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals