CMS Price Transparency Data
Ultrasound, leg veins (duplex)
Facility: Mercy Hospital Springfield
Billing Code: 93970 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93970
- Insurance Median: $914
- Cash Discount Price: $1,320
- vs. Medicare Baseline: 3.75x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercy Hospital Springfield is $914. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,320. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.75x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$1,320
Average discount available for prompt cash payment at this facility.
Insurance Median
$914
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: $1,320 (541%)
Insurance Median: $914 (375%)
Cash: $1,320 (541% of Medicare)
Ins. Median: $914 (375% 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 375% of the Medicare baseline (a markup of 275%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 - $827 | 17% |
| Blue Cross Blue Shield | $79 - $1,552 | 32% |
| Aetna | $158 - $1,016 | 65% |
| Humana | $158 - $1,381 | 65% |
| Centurion Of Missouri [20459] | $215 | 88% |
| 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% |
| Indian Health Service Contracted [320198] | $215 | 88% |
| Indian Health Service [20198] | $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% |
| Mercy Rehab Hospital Contracted [320260] | $215 | 88% |
| Pace Of The Ozarks Contracted [320518] | $215 | 88% |
| Qual Choice Contracted [320325] | $215 | 88% |
| Tricare | $215 | 88% |
| UnitedHealthcare | $215 - $1,564 | 88% |
| Provider Partners Health Plans Contracted [320450] | $237 | 97% |
| Healthscope Contracted [320182] | $274 | 112% |
| Centivo Contracted [320505] | $361 | 148% |
| Providrs Care Network Contracted [320484] | $447 | 183% |
| United Medical Resources Contracted [320454] | $483 - $1,056 | 198% |
| Medica Contracted [320239] | $802 | 329% |
| Medica [20239] | $802 | 329% |
| Benefit Management Contracted [320052] | $812 | 333% |
| Health Systems Inc Contracted [320174] | $812 | 333% |
| Insurance System Inc Contracted [320465] | $812 | 333% |
| Ambetter / Centene | $827 | 339% |
| Home State Health Plan Contracted [320187] | $827 | 339% |
| Novasys Contracted [320285] | $827 | 339% |
| Administrative Payor Contracted [320005] | $914 - $1,016 | 375% |
| Evolutions Health Care Contracted [320124] | $914 | 375% |
| Point C Contracted [320238] | $914 - $1,523 | 375% |
| Point C [20238] | $914 | 375% |
| Medical Destinations Contracted [320242] | $1,016 | 417% |
| Mercy Benefit Admin Contracted [320251] | $1,016 - $1,219 | 417% |
| Workers Comp [20426] | $1,016 - $1,726 | 417% |
| First Health Contracted [320128] | $1,137 | 466% |
| Aither Health Contracted [320449] | $1,158 | 475% |
| Auxiant Contracted [320462] | $1,158 - $1,320 | 475% |
| Ebms Contracted [320493] | $1,158 | 475% |
| Edison Health Solutions Contracted [320502] | $1,158 | 475% |
| Healthlink Contracted [320179] | $1,158 - $1,625 | 475% |
| Imagine 360 Contracted [320494] | $1,158 | 475% |
| Reflect Health Contracted [320492] | $1,158 | 475% |
| Yuzu Health Contracted [320521] | $1,158 | 475% |
| 90 Degree Benefits Contracted [320436] | $1,219 | 500% |
| Federal Medical Center Contracted [320127] | $1,219 | 500% |
| Show-Me Health Administrators Contracted [320483] | $1,219 | 500% |
| Multiplan Contracted [320270] | $1,564 | 642% |
| Private Health Care Systems Contracted [320320] | $1,564 | 642% |
| Compcare Of The Ozarks Contracted [320437] | $1,604 | 658% |
| American Healthcare Alliance Contracted [320020] | $1,625 | 667% |
| Qual Choice Contracted [320324] | $1,625 | 667% |
| Municipal Health Plan Contracted [320271] | $1,645 | 675% |
| Usa Managed Care Org Contracted [320429] | $1,787 | 733% |
| Ppo Plus Contracted [320310] | $1,828 | 750% |