Ultrasound, leg veins (duplex)
Facility: Wesley Medical Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $643
- Cash Discount Price: $3,366
- vs. Medicare Baseline: 2.64x 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 264% of the Medicare baseline (a markup of 164%). 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 |
|---|---|---|
| UnitedHealthcare | $79 | 32% |
| Medicaid / KanCare | $82 | 34% |
| Amerigroup | $83 | 34% |
| Aetna | $83 - $1,202 | 34% |
| Blue Cross Blue Shield | $390 | 160% |
| United | $508 - $1,515 | 208% |
| Health Partners Of Kansas | $582 - $1,683 | 239% |
| Wppa | $586 | 240% |
| Ambetter / Centene | $606 | 249% |
| Medical Associates Health Plan | $636 | 261% |
| Preferred Health Choices | $636 | 261% |
| Spirit Aerosystems | $1,077 | 442% |
| First Health | $1,552 | 637% |
| Triwest Healthcare Alliance | $2,188 | 898% |
| Multiplan | $2,356 - $3,029 | 966% |
| Usa Managed Care | $2,861 | 1174% |
Consumer Guidance & Cost Commentary
For the CPT code 93970, representing an ultrasound of leg veins, the cash price at Wesley Medical Center in Wichita, KS, is $3,366. This cash rate is significantly higher than the state average, which is approximately 2.6 times the Medicare benchmark of $243.77. While commercial insurance plans like Aetna and Multiplan offer negotiated rates ranging from $79 to over $3,000 depending on the specific plan, these amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates for many payers are higher than the facility's cash rate. It is important to note that while the facility offers a cash median of $3,366, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can reduce the final cost.
The data indicates that while some payers like UnitedHealthcare and Medicaid/KanCare have a single plan with a low allowed amount of $79, others such as Multiplan and Triwest Healthcare Alliance have negotiated rates that can reach $3,029 and $2,188 respectively. Because commercial rates are often inflated by administrative processing and contract structures, the cash price can serve as a more transparent baseline for comparison. To avoid unexpected costs, patients should request an itemized bill to review specific CPT codes and ensure no unbundled charges or services not rendered are included. If a balance bill arises from out-of-network ancillary services, patients should be aware of the No Surprises Act protections and should not sign away their