CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Monument Health Rapid City Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $976
  • Cash Discount Price: $1,457
  • vs. Medicare Baseline: 4.00x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Monument Health Rapid City Hospital is $976. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,457. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.00x the Medicare baseline. Located in 353 Fairmont Blvd, Rapid City, SD.
Cash / Self-Pay
$1,457

Average discount available for prompt cash payment at this facility.

Insurance Median
$976

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: $1,457 (598%)
Insurance Median: $976 (400%)
Cash: $1,457 (598% of Medicare)
Ins. Median: $976 (400% 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 400% of the Medicare baseline (a markup of 300%). 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
UnitedHealthcare $182 - $962 75%
Va Black Hills Health Care System 12115 [3081206] $182 75%
Humana $191 - $1,311 78%
Risk Admin Svs [3081167] $232 - $1,166 95%
Tricare $235 - $408 96%
Healthpartners [3081368] $251 103%
Minnesota Health Care Programs 12K16 [3081295] $441 181%
Blue Cross Blue Shield $455 187%
Health Partners Sx009 [3081102] $903 370%
Coresource 38225 [3081146] $947 - $991 388%
Govt Employees Health Assn [3081090] $962 395%
National Telephone Cooperative Assn 52103 [3081149] $962 395%
Surest [3081369] $962 395%
United Medical Resources 39026 [3081194] $962 395%
Avera Health Plans 46045 [3081018] $1,071 439%
Rocky Mountain Admin Llc 83028 [3081168] $1,166 478%
Medica (Commercial) 94265 [3081118] $1,209 496%
Employee Benefit Management 12X44 [3081079] $1,238 508%
Pacificsource Health Plans [3081333] $1,238 508%
Aetna $1,311 538%
Group And Pension Administrators Inc [3081098] $1,311 538%
Multiplan Inc 34080 [3081285] $1,311 538%
Sanford Health Plan 91184 [3081174] $1,311 538%
Tlc Advantage Llc [3081189] $1,370 562%
Fedmed Inc [3081283] $1,384 568%
Allied Benefit Systems Inc [3081320] $1,399 574%
Cigna $1,399 574%
Key Benefit Administrators [3081332] $1,399 574%
Meritain Health [3081135] $1,399 574%
Midlands Choice 47080 [3081136] $1,399 574%
Preferred One 41147 [3081160] $1,399 574%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 353 Fairmont Blvd, Rapid City, SD 57701
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals