Ultrasound, leg veins (duplex)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $826
- Cash Discount Price: $495
- vs. Medicare Baseline: 3.39x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 339% of the Medicare baseline (a markup of 239%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthcare Highways [2210] | $677 | 278% |
| Blue Cross Blue Shield | $677 | 278% |
| Black Lung [6055] | $677 | 278% |
| Web Tpa [2115] | $677 | 278% |
| Lucent Health [6000] | $677 | 278% |
| Aetna | $677 | 278% |
| Oncology Patient Assistance Programs [2295] | $677 | 278% |
| Hooray Health [8000] | $677 | 278% |
| Department Of Corrections [1340] | $826 | 339% |
| National Association Of Letter Carriers [1695] | $954 | 391% |
| American Postal Workers Union [1070] | $954 | 391% |
| Healthpartners [1500] | $954 | 391% |
| Cigna | $954 | 391% |
| Humana | $974 | 400% |
| 1199 Seiu Benefit Fund [3505] | $1,111 | 456% |
| Enablecomp [1350] | $1,156 | 474% |
| Worker'S Comp [2125] | $1,156 | 474% |
| First Health [1375] | $1,283 | 526% |
| American Healthcare [1055] | $1,283 | 526% |
| Administrative Concepts [1005] | $1,283 | 526% |
| Multiplan [1680] | $1,283 | 526% |
| Coventry Healthcare [1320] | $1,354 | 555% |
| Ks Disability Determination [6090] | $1,651 | 677% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at the University of Kansas Health System - St Francis Campus in Topeka, KS, the facility's negotiated rates range from $677 to $1,651 depending on the insurance carrier, while the cash-pay median is significantly lower at $495. This cash price is notably lower than the facility's own negotiated rates, illustrating that patients with high-deductible plans or those without insurance may save money by paying out-of-pocket. It is important to note that while the facility is a voluntary non-profit church-owned acute care hospital, the cash rate of $495 does not align with the state or county averages provided in this dataset, which are not explicitly listed for this specific code. Patients should verify their specific plan's allowed amount, as some commercial payers may negotiate rates that exceed the cash price, making self-pay or prompt-pay discounts a viable option to reduce costs.
The data indicates that the facility's gross charge of $1,651 is 3.4 times the Medicare benchmark of $243.77, highlighting a substantial markup common in commercial billing. Under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, though they should still request an itemized bill to ensure no unbundled codes or services not rendered are included. If a patient receives a bill exceeding the negotiated rate, they should dispute it in writing rather than paying immediately, as many errors can be corrected through a formal audit. Additionally, patients should confirm whether their specific insurance plan has a deductible that must be met before the negotiated rate applies, as paying the full negotiated amount without meeting this threshold can result