CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Howard County Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $626
Cash Discount Price: $1,498
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Howard County Medical Center is $626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,498. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.57x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.

Cash / Self-Pay

$1,498

Average discount available for prompt cash payment at this facility.

Insurance Median

$626

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: $1,498 (615%)

Insurance Median: $626 (257%)

Cash: $1,498 (615% of Medicare)

Ins. Median: $626 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Medica Standard Premier	$30 - $169	12%
Aetna	$31 - $1,423	13%
Medica Elevate	$58 - $330	24%
Midland'S Choice	$61 - $347	25%
UnitedHealthcare	$126 - $1,438	52%
Humana	$140	57%
Blue Cross Blue Shield	$164 - $1,423	67%
Great Plains	$164 - $854	67%
Medica Chi	$164 - $854	67%
Tricare	$164 - $1,124	67%
Nebraska Total Care - Wellcare	$169	69%
Molina Healthcare	$173 - $749	71%
Oscar Health	$288	118%
Ambetter / Centene	$329	135%
Beshp	$329	135%
Nebraska Total Care	$749	307%
Medica Chi Aco	$1,363	559%
Medica Choice National	$1,363	559%
Medica Ifb Aco	$1,438	590%
Medica Ifb Open Access	$1,438	590%

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 $1,498.
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 Howard County Medical Center 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.