CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Sanford Usd Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $651
  • Cash Discount Price: $1,437
  • vs. Medicare Baseline: 2.67x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Sanford Usd Medical Center is $651. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,437. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.67x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.
Cash / Self-Pay
$1,437

Average discount available for prompt cash payment at this facility.

Insurance Median
$651

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: $1,437 (589%)
Insurance Median: $651 (267%)
Cash: $1,437 (589% of Medicare)
Ins. Median: $651 (267% 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 267% of the Medicare baseline (a markup of 167%). 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 $109 - $308 45%
Sanford Health Plan $187 77%
Sanford Health Plan Align $230 94%
Ucare $247 - $1,262 101%
Aetna $249 - $1,374 102%
Health Partners $249 - $700 102%
Medicare (plans) $249 102%
UnitedHealthcare $249 - $1,582 102%
Primewest $254 - $257 104%
Security Health Plan $988 405%
Medica $1,210 - $1,295 496%
First Choice Health Network $1,616 663%
Healthez $1,616 663%
Multiplan $1,616 663%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals