CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mercy Hospital Carthage

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $802
Cash Discount Price: $802
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercy Hospital Carthage is $802. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $802. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.29x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$802

Average discount available for prompt cash payment at this facility.

Insurance Median

$802

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: $802 (329%)

Insurance Median: $802 (329%)

Cash: $802 (329% of Medicare)

Ins. Median: $802 (329% 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 329% of the Medicare baseline (a markup of 229%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$79 - $913	32%
Medicaid / KanCare	$79 - $677	32%
Aetna	$158 - $1,098	65%
Humana	$158 - $370	65%
Medicare (plans)	$226 - $365	93%
UnitedHealthcare	$317 - $1,074	130%
Cherokee Nation Health Serv Contracted [320066]	$339	139%
Cigna	$339 - $1,111	139%
Cross Timbers Hospice [20098]	$339	139%
Dept Of Veteran Affairs Contracted [320106]	$339	139%
Elara Caring Aspire Hospice [20433]	$339	139%
Globalhealth Contracted [320145]	$339	139%
Halo Hcr Inc Hospice Contracted [320432]	$339	139%
Halo Hcr Inc Hospice [20432]	$339	139%
Indian Health Service Contracted [320198]	$339	139%
Kindful Hospice Contracted [320434]	$339	139%
Kindful Hospice [20434]	$339	139%
Medical Associates Health Contracted [320444]	$339	139%
Mercy Hospice Okc [20252]	$339	139%
Mercy Mgd Behavioral Health Contracted [320259]	$339	139%
Pace Of The Ozarks Contracted [320518]	$339	139%
Provider Partners Health Plans Contracted [320450]	$339	139%
Qual Choice Contracted [320325]	$339	139%
Tricare	$340	139%
Point C Contracted [320238]	$432 - $1,111	177%
Health Systems Inc Contracted [320174]	$531	218%
Insurance System Inc Contracted [320465]	$531	218%
Administrative Payor Contracted [320005]	$555	228%
Centivo Contracted [320505]	$568	233%
Healthscope Contracted [320182]	$643	264%
Ambetter / Centene	$677	278%
Home State Health Plan Contracted [320187]	$677	278%
Novasys Contracted [320285]	$677	278%
Benefit Management Contracted [320052]	$740 - $1,074	304%
Auxiant Contracted [320462]	$802 - $1,049	329%
Healthlink Contracted [320179]	$802 - $1,148	329%
Preferred Health Plan Contracted [320522]	$802	329%
Workers Comp [20426]	$987 - $1,234	405%
United Medical Resources Contracted [320454]	$1,024 - $1,111	420%
90 Degree Benefits Contracted [320436]	$1,049	430%
Aither Health Contracted [320449]	$1,049	430%
Ebms Contracted [320493]	$1,049	430%
Edison Health Solutions Contracted [320502]	$1,049	430%
Imagine 360 Contracted [320494]	$1,049	430%
Mercy Benefit Admin Contracted [320251]	$1,049 - $1,111	430%
Reflect Health Contracted [320492]	$1,049	430%
Show-Me Health Administrators Contracted [320483]	$1,049	430%
Yuzu Health Contracted [320521]	$1,049	430%
Medica Contracted [320239]	$1,069	439%
Evolutions Health Care Contracted [320124]	$1,074	441%
First Health Contracted [320128]	$1,074	441%
Multiplan Contracted [320270]	$1,074	441%
Private Health Care Systems Contracted [320320]	$1,074	441%
American Healthcare Alliance Contracted [320020]	$1,111	456%
Ppo Plus Contracted [320310]	$1,111	456%
Usa Managed Care Org Contracted [320429]	$1,111	456%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $802.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93970.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Carthage is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93970.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.