Ultrasound, leg veins (duplex)
Facility: Lmh
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $240
- Cash Discount Price: $321
- vs. Medicare Baseline: 0.98x 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 | $80 - $854 | 33% |
| Blue Cross Blue Shield | $80 - $832 | 33% |
| Cigna | $90 - $859 | 37% |
| Medicare (plans) | $90 - $240 | 37% |
| Humana | $90 - $240 | 37% |
| Haskell Indian Health Services | $105 - $240 | 43% |
| Ambetter / Centene | $107 - $372 | 44% |
| Allwell | $107 - $245 | 44% |
| Aetna | $819 - $1,067 | 336% |
| Non Contracted | $1,029 | 422% |
| First Health | $1,196 | 491% |
Consumer Guidance & Cost Commentary
For CPT code 93970, an ultrasound of the leg veins, the facility in Lawrence, KS, lists a gross charge of $1,286. While the Medicare benchmark for this service is $243.77, the facility's cash median rate is $321, which is significantly lower than the gross charge. This cash rate is also notably lower than the negotiated rates paid by major commercial payers like UnitedHealthcare and Blue Cross Blue Shield, which range from $80 to $854 and $80 to $832 respectively across their respective plans. Patients with high-deductible plans or those without insurance may find the cash price advantageous, as it avoids the administrative markup inherent in commercial contracts. It is important to note that while the facility is government-owned, the cash rate does not automatically apply to insured patients; commercial members are typically billed the negotiated amount unless they qualify for specific discounts.
To minimize potential costs, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the higher negotiated rates charged to insurers. If a patient receives an out-of-network bill, they should be aware of the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities, and should dispute any unexpected charges in writing rather than paying immediately. Furthermore, since over 80% of hospital bills contain errors, patients should request a full itemized statement to verify that all services rendered are accurately coded and that no unbundled charges or services not delivered have been included. Comparing the facility's rates to the broader market, the cash price of $32