Ultrasound, leg veins (duplex)
Facility: Stormont Vail Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $218
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.89x 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 |
|---|---|---|
| UnitedHealthcare | $81 - $202 | 33% |
| Ambetter / Centene | $81 - $202 | 33% |
| Blue Cross Blue Shield | $82 - $741 | 34% |
| Aetna | $218 - $222 | 89% |
| Humana | $218 - $222 | 89% |
Consumer Guidance & Cost Commentary
For the CPT code 93970, representing an ultrasound of leg veins, Stormont Vail Hospital in Topeka, KS, has a gross charge of $1,388.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $81.00 to $222.00, the median negotiated payment across all five payers is $218.00. This amount is significantly lower than the facility's gross charge, reflecting standard insurance contract caps. It is important to note that cash-pay options are not listed for this specific service, so patients relying on self-pay or prompt-pay discounts should verify directly with the hospital's billing department, as these incentives are not automatically applied to insurance claims.
When evaluating the cost relative to the national standard, the facility's median paid amount of $222.00 is 90% of the Medicare amount of $243.77, indicating a pricing structure that aligns closely with federal benchmarks. Although specific county or state average data was not provided in the source material, the facility's location in Topeka (ZIP 66604) and its status as a voluntary non-profit acute care hospital are relevant context for understanding regional pricing dynamics. Patients should be aware that while insurance typically covers a portion of the cost, the final out-of-pocket expense depends on individual plan deductibles and co-pays, and any balance billing is generally prohibited for in-network services at this facility under federal protections.