CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Holmes County Hospital and Clinics

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $566
  • Cash Discount Price: $302
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Holmes County Hospital and Clinics is $566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.32x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.
Cash / Self-Pay
$302

Average discount available for prompt cash payment at this facility.

Insurance Median
$566

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: $302 (124%)
Insurance Median: $566 (232%)
Cash: $302 (124% of Medicare)
Ins. Median: $566 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Ms-Can-Molina-Lex $190 78%
Ms-Can-Magnolia-Lex $192 79%
Ms-Can-Truecare-Lex $193 79%
Molina-Chip-Lex $405 166%
Magnolia-Chip-Lex $414 170%
Truecare-Chip-Lex $414 170%
Cigna $437 179%
Tricare $463 190%
Humana $470 193%
Advhealth-Lex $486 199%
Mpcn-Lex $490 201%
Medadv_Uhc-Lex $513 210%
Firstchoice-Lex $528 217%
United-Lex $562 231%
Ambetter / Centene $566 232%
Medadv_Primewell-Lex $566 232%
Medicare (plans) $566 232%
Primewell-Lex $566 232%
United-Options-Lex $566 232%
Va_Ccn-Lex $566 232%
Medadv_Uhcdsnp-Lex $582 239%
Wellcare-Lex $582 239%
Ppoplus $588 241%
Devoted_Health-Lex $594 244%
Firsthealth-Lex $603 247%
Multiplan-Lex $603 247%
Aetna $641 263%
Phcs-Lex $679 279%
Blue Cross Blue Shield $711 292%
Molina_Exchange-Lex $754 309%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 239 Bowling Green Road, Lexington, MS 39095
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals