CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Louis Childrens Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $774
  • Cash Discount Price: $628
  • vs. Medicare Baseline: 3.18x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Louis Childrens Hospital is $774. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $628. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.18x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.
Cash / Self-Pay
$628

Average discount available for prompt cash payment at this facility.

Insurance Median
$774

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: $628 (258%)
Insurance Median: $774 (318%)
Cash: $628 (258% of Medicare)
Ins. Median: $774 (318% 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 318% of the Medicare baseline (a markup of 218%). 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
Aetna $235 - $826 96%
Blue Cross Blue Shield $235 - $889 96%
Essence Healthcare [221] $235 96%
Humana $235 - $779 96%
UnitedHealthcare $235 - $777 96%
Cox Health [757] $247 101%
Medica [662] $247 101%
Healthlink [225] $507 - $790 208%
Cigna $517 - $568 212%
Consociate [478] $567 233%
Sarah Bush Lincoln [636] $567 233%
Apwu Health Plan [216] $568 233%
Nalc Health Benefit Plan [242] $568 233%
Priority Health [648] $568 233%
Allied Benefits [498] $607 - $826 249%
Hope Trust [806] $607 249%
Cox Health Systems Insurance Company [220] $680 - $774 279%
Med-Pay [480] $680 - $784 279%
Unicare [568] $680 - $790 279%
Health Alliance [224] $732 300%
Healthscope Benefits [258] $746 - $837 306%
First Health Commercial [734] $777 319%
Beechstreet [551] $784 322%
Detego Health [868] $784 322%
Health Systems Inc [620] $784 322%
Healthcare Sol Mercy [609] $784 322%
Multiplan Commercial [737] $784 322%
Multiplan [240] $784 322%
Phcs [244] $784 - $837 322%
Preferred Health Professionals [561] $790 324%
Coresource [497] $826 339%
Fmh Benefit Service Inc [222] $826 339%
Mail Handlers [495] $826 339%
Medica [661] $837 343%
Hfn [563] $889 365%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Childrens Place, Saint Louis, MO 63110
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens