Ultrasound, leg veins (duplex)
Facility: Pratt Regional Medical Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $417
- Cash Discount Price: $666
- vs. Medicare Baseline: 1.71x 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.
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 |
|---|---|---|
| Celtic Insurance Company | $227 | 93% |
| Healthy Blue | $234 | 96% |
| UnitedHealthcare | $250 - $1,515 | 103% |
| Christian Health Aid | $313 - $1,114 | 128% |
| Health Partners Of Kansas | $354 - $1,262 | 145% |
| Aetna | $375 - $1,337 | 154% |
| Choicecare | $417 - $1,485 | 171% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Pratt Regional Medical Center in Pratt, KS, the facility's cash price of $666.00 is significantly lower than the negotiated rates charged to insurance plans, which range from $227 to $1,485 depending on the carrier. While the facility's cash rate is higher than the state average, it remains below the gross chargemaster price of $951.00. Patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance allowed amount, as commercial negotiated rates often include administrative overhead that exceeds the actual cost of care. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can further reduce the final cost.
The Medicare benchmark for this service is $243.77, which serves as a reliable baseline for evaluating pricing fairness, as commercial rates are frequently marked up significantly above this federal standard. Although the data does not provide a specific median paid amount for this code, the facility's cash rate of $666.00 is notably higher than the cash median of $666.00 reported for the region, suggesting this specific procedure may carry a standard markup. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is essential to request a detailed, itemized bill to verify that all charges align with the negotiated or cash rates and to identify any potential errors or unbundled codes before payment is finalized.