Ultrasound, leg veins (duplex)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $224
- Cash Discount Price: $485
- vs. Medicare Baseline: 0.92x 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 | $38 - $626 | 16% |
| Aetna | $39 - $206 | 16% |
| Medicaid / KanCare | $39 - $206 | 16% |
| Providrs Care | $40 - $229 | 16% |
| Tricare | $155 | 64% |
| Va | $224 | 92% |
| Medicare (plans) | $224 - $228 | 92% |
| Humana | $224 - $226 | 92% |
| Smarthealth | $313 | 128% |
| Ambetter / Centene | $380 | 156% |
| Blue Cross Blue Shield | $521 - $548 | 214% |
Consumer Guidance & Cost Commentary
For CPT code 93970, an ultrasound of the leg veins, Ascension Via Christi Hospital Manhattan, Inc. lists a cash price of $485.00, which is notably lower than the facility's negotiated rates for commercial payers like UnitedHealthcare (ranging from $38 to $626) and Aetna (ranging from $39 to $206). While the facility's negotiated median is $224.00, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds $485.00, as paying out-of-pocket avoids the administrative overhead often embedded in commercial contracts. It is important to verify your specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest possible price can lead to unexpected costs if the insurer's negotiated rate is higher than the cash rate.
The facility's pricing is benchmarked against Medicare, which sets a fixed rate of $243.77 for this procedure. The cash price of $485.00 represents a markup of approximately 100% over the Medicare amount, while the facility's negotiated rates for commercial insurers generally range from 1.5x to 2.5x the Medicare rate. For example, UnitedHealthcare's maximum negotiated rate of $626.00 is significantly higher than the Medicare benchmark, whereas Medicaid/KanCare and Tricare have fixed negotiated rates of $39.00 and $155.00 respectively, which are lower than the cash price. Patients should consider requesting a prompt-pay discount, which can reduce the cash balance by