CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Lafayette Regional Health Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $2,348
  • Cash Discount Price: $5,590
  • vs. Medicare Baseline: 9.63x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Lafayette Regional Health Center is $2,348. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,590. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.63x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$5,590

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,348

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: $5,590 (2293%)
Insurance Median: $2,348 (963%)
Cash: $5,590 (2293% of Medicare)
Ins. Median: $2,348 (963% 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 963% of the Medicare baseline (a markup of 863%). 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
United $79 - $2,515 32%
Healthyblue $81 33%
Medicaid / KanCare $82 34%
Aetna $83 - $4,891 34%
Amerigroup $83 34%
Home State Health Plan $83 34%
Unicare $83 34%
Ambetter / Centene $1,040 427%
Nhc Advantage $1,062 436%
Universal Healthcare $1,453 596%
Humana $1,889 - $2,404 775%
Blue Cross Blue Shield $2,124 - $5,590 871%
College Park Family Care Center $2,404 986%
Oha Network $2,795 1147%
Oscar $2,795 1147%
Cigna $3,193 - $3,991 1310%
Wppa Providrs Care Network $4,192 1720%
Multiplan $4,360 1789%
Coventry $4,460 1830%
Coventry Kc Mo $4,460 1830%
Cco, Inc. $4,751 1949%
Corvel Corporation $4,751 1949%
Focus Healthcare Mgmt, Inc $5,031 2064%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals