CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Hermann Area District Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $512
  • Cash Discount Price: $698
  • vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Hermann Area District Hospital is $512. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $698. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.10x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.
Cash / Self-Pay
$698

Average discount available for prompt cash payment at this facility.

Insurance Median
$512

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: $698 (286%)
Insurance Median: $512 (210%)
Cash: $698 (286% of Medicare)
Ins. Median: $512 (210% 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 210% of the Medicare baseline (a markup of 110%). 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.

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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
Harmony Hp Mcaid- All Plans $50 21%
Care Partners Mcaid- All Plans $52 21%
Ambetter / Centene $100 - $152 41%
Healthy Blue Mcaid - All Plans $146 60%
Blue Cross Blue Shield $158 - $947 65%
UnitedHealthcare $158 - $488 65%
Tricare $461 189%
Choicecare Mcr Adv- All Plans $488 200%
American Hlth Mcr Adv- All Plans $512 210%
Humana $512 210%
Aetna $522 - $1,105 214%
Wellcare Mcr Adv - All Plans $522 214%
Cigna $691 283%
Healthcare Usa Mcaid- All Plans $756 310%
Healthlink Hmo $756 310%
Healthlink Ppo - All Other Plans $872 358%
Multiplan/Phcs - All Plans $872 358%
Coventry - All Plans $989 406%
Comp Results - All Plans $1,047 430%
Three Rivers - All Plans $1,047 430%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 W 18Th St, Hermann, MO 65041
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals