CMS Price Transparency Data
Ultrasound, leg veins (duplex)
Facility: Mercy Hospital Oklahoma City, Inc
Billing Code: 93970 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93970
- Insurance Median: $1,155
- Cash Discount Price: $1,533
- vs. Medicare Baseline: 4.74x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercy Hospital Oklahoma City, Inc is $1,155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,533. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.74x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$1,533
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,155
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: $1,533 (629%)
Insurance Median: $1,155 (474%)
Cash: $1,533 (629% of Medicare)
Ins. Median: $1,155 (474% 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 474% of the Medicare baseline (a markup of 374%). 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 |
|---|---|---|
| Medicaid / KanCare | $42 - $310 | 17% |
| Aetna | $158 - $1,705 | 65% |
| Humana | $158 - $1,627 | 65% |
| Tricare | $214 - $226 | 88% |
| Blue Cross Blue Shield | $226 - $242 | 93% |
| Champva [20065] | $226 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $226 | 93% |
| Cross Timbers Hospice [20098] | $226 | 93% |
| Dept Of Veteran Affairs Contracted [320106] | $226 | 93% |
| Elara Caring Aspire Hospice Contracted [320433] | $226 | 93% |
| Elara Caring Aspire Hospice [20433] | $226 | 93% |
| Halo Hcr Inc Hospice Contracted [320432] | $226 | 93% |
| Halo Hcr Inc Hospice [20432] | $226 | 93% |
| Indian Health Service Contracted [320198] | $226 | 93% |
| Kindful Hospice Contracted [320434] | $226 | 93% |
| Kindful Hospice [20434] | $226 | 93% |
| Longevity Health Plan [10477] | $226 | 93% |
| Medicare (plans) | $226 - $241 | 93% |
| Mercy Hospice Okc [20252] | $226 | 93% |
| Mercy Rehab Hospital Contracted [320260] | $226 | 93% |
| Provider Partners Health Plans Contracted [320450] | $226 | 93% |
| Qual Choice Contracted [320325] | $226 | 93% |
| UnitedHealthcare | $226 - $436 | 93% |
| Globalhealth Contracted [320145] | $230 | 94% |
| Cigna | $232 - $1,410 | 95% |
| Amg Spec Hosp Edmond [20034] | $241 | 99% |
| Ambetter / Centene | $310 | 127% |
| Home State Health Plan Contracted [320187] | $310 | 127% |
| Novasys Contracted [320285] | $310 | 127% |
| Community Care Contracted [320080] | $345 - $1,651 | 142% |
| Health Choice Contracted [320166] | $435 | 178% |
| United Medical Resources Contracted [320454] | $436 - $1,533 | 179% |
| Healthsmart Preferred Care Contracted [320184] | $508 - $1,533 | 208% |
| Kempton Contracted [320214] | $508 | 208% |
| Medica Contracted [320239] | $747 | 306% |
| Healthcare Highways Plus Contracted [320175] | $920 - $1,415 | 377% |
| Webtpa Contracted [320417] | $990 | 406% |
| Osma Health Contracted [320292] | $1,061 | 435% |
| Aither Health Contracted [320449] | $1,415 | 580% |
| Auxiant Contracted [320462] | $1,415 - $1,533 | 580% |
| Benefit Management Contracted [320052] | $1,415 - $1,533 | 580% |
| Ebms Contracted [320493] | $1,415 | 580% |
| Healthlink Contracted [320179] | $1,415 - $1,533 | 580% |
| Imagine 360 Contracted [320494] | $1,415 | 580% |
| Mercy Benefit Admin Contracted [320251] | $1,415 - $1,533 | 580% |
| Quik Trip Contracted [320447] | $1,415 | 580% |
| Reflect Health Contracted [320492] | $1,415 | 580% |
| Show-Me Health Administrators Contracted [320483] | $1,415 | 580% |
| Workers Comp [20426] | $1,415 | 580% |
| Yuzu Health Contracted [320521] | $1,415 | 580% |
| First Health Contracted [320128] | $1,453 | 596% |
| Federal Medical Center Contracted [320127] | $1,533 | 629% |
| Healthscope Contracted [320182] | $1,533 | 629% |
| Healthsmart Accel Contracted [320183] | $1,533 | 629% |
| Point C Contracted [320238] | $1,533 | 629% |
| Preferred Health Plan Contracted [320522] | $1,533 | 629% |
| Private Health Care Systems Contracted [320320] | $1,533 - $1,651 | 629% |
| Tri State Healthcare Coalition Contracted [320379] | $1,533 | 629% |
| Multiplan Contracted [320270] | $1,651 - $2,122 | 677% |
| Globalhealth Contracted [320144] | $1,674 | 687% |
| Preferred Community Choice Contracted [320311] | $1,792 | 735% |
| Centralink Contracted [320480] | $2,358 | 967% |