CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: PAM Rehabilitation Hospital of Fargo

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $500
  • Cash Discount Price: $715
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at PAM Rehabilitation Hospital of Fargo is $500. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $715. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.05x the Medicare baseline. Located in 4671 38Th St S, Fargo, ND.
Cash / Self-Pay
$715

Average discount available for prompt cash payment at this facility.

Insurance Median
$500

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: $715 (293%)
Insurance Median: $500 (205%)
Cash: $715 (293% of Medicare)
Ins. Median: $500 (205% 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 205% of the Medicare baseline (a markup of 105%). 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
Blue Cross Blue Shield $140 - $166 57%
Primewest Minnesota $140 57%
Ucare Of Minnesota $140 57%
Medica $152 - $303 62%
Aetna $197 81%
Sanford Health Plan $332 136%
Cigna $429 - $500 176%
Ilumed Aco Reach $465 191%
Americas Choice Provider Network $500 205%
Provider Network Of America $536 220%
Quik Trip $536 220%
Usa Managed Care Organization $536 220%
Velocity Provider Ppo Network $536 220%
Multiplan/Phcs $572 235%
Prime Health Services $607 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4671 38Th St S, Fargo, ND 58104
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL