CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Mercy Hospital Ada

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $955
  • Cash Discount Price: $1,128
  • vs. Medicare Baseline: 3.92x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Mercy Hospital Ada is $955. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,128. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.92x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$1,128

Average discount available for prompt cash payment at this facility.

Insurance Median
$955

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: $1,128 (463%)
Insurance Median: $955 (392%)
Cash: $1,128 (463% of Medicare)
Ins. Median: $955 (392% 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 392% of the Medicare baseline (a markup of 292%). 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
Aetna $158 - $1,305 65%
Humana $158 - $246 65%
Medicaid / KanCare $158 - $332 65%
Blue Cross Blue Shield $242 99%
Cherokee Nation Health Serv Contracted [320066] $242 99%
Cross Timbers Hospice [20098] $242 99%
Dept Of Veteran Affairs Contracted [320106] $242 99%
Elara Caring Aspire Hospice Contracted [320433] $242 99%
Elara Caring Aspire Hospice [20433] $242 99%
Halo Hcr Inc Hospice Contracted [320432] $242 99%
Halo Hcr Inc Hospice [20432] $242 99%
Independent Health [20197] $242 99%
Indian Health Service Contracted [320198] $242 99%
Kindful Hospice Contracted [320434] $242 99%
Kindful Hospice [20434] $242 99%
Medical Associates Health [20444] $242 99%
Medicare (plans) $242 - $1,736 99%
Mercy Hospice Okc [20252] $242 99%
Provider Partners Health Plans Contracted [320450] $242 99%
Qual Choice Contracted [320325] $242 99%
Tricare $242 99%
UnitedHealthcare $242 - $1,215 99%
Globalhealth Contracted [320145] $246 101%
Cigna $249 102%
Ambetter / Centene $332 136%
Home State Health Plan Contracted [320187] $332 136%
Novasys Contracted [320285] $332 136%
Health Choice Contracted [320166] $483 198%
Healthsmart Preferred Care Contracted [320184] $544 223%
Kempton Contracted [320214] $544 223%
Healthcare Highways Plus Contracted [320175] $677 - $1,302 278%
Webtpa Contracted [320417] $729 299%
Osma Health Contracted [320292] $781 320%
Medica Contracted [320239] $809 - $1,736 332%
Benefit Management Contracted [320052] $868 - $1,128 356%
Aither Health Contracted [320449] $1,042 427%
Auxiant Contracted [320462] $1,042 427%
Ebms Contracted [320493] $1,042 427%
Federal Medical Center Contracted [320127] $1,042 427%
Healthlink Contracted [320179] $1,042 427%
Healthscope Contracted [320182] $1,042 427%
Imagine 360 Contracted [320494] $1,042 427%
Mercy Benefit Admin Contracted [320251] $1,042 - $1,128 427%
Point C Contracted [320238] $1,042 427%
Preferred Health Plan Contracted [320522] $1,042 427%
Quik Trip Contracted [320447] $1,042 427%
Reflect Health Contracted [320492] $1,042 427%
Show-Me Health Administrators Contracted [320483] $1,042 427%
United Medical Resources Contracted [320454] $1,042 - $1,215 427%
Workers Comp [20426] $1,042 427%
Yuzu Health Contracted [320521] $1,042 427%
Globalhealth Contracted [320144] $1,094 449%
First Health Contracted [320128] $1,443 592%
Multiplan Contracted [320270] $1,476 605%
Private Health Care Systems Contracted [320320] $1,476 605%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals