Ultrasound, leg veins (duplex)
Facility: Saint Luke'S South Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $1,464
- Cash Discount Price: $1,952
- vs. Medicare Baseline: 6.01x 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 601% of the Medicare baseline (a markup of 501%). 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 |
|---|---|---|
| Medicaid / KanCare | $79 - $309 | 32% |
| Cigna | $292 - $2,470 | 120% |
| Blue Cross Blue Shield | $408 - $2,444 | 167% |
| UnitedHealthcare | $426 - $994 | 175% |
| Commercial-Contracted [8000] | $460 - $2,632 | 189% |
| Humana | $1,041 - $2,127 | 427% |
| Transplants-Case Rates [5750] | $1,139 - $3,254 | 467% |
| Aetna | $1,176 - $3,091 | 482% |
| First Health [5512] | $1,929 | 791% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Saint Luke's South Hospital in Overland Park, KS, the cash price is $1,952, which is lower than the facility's negotiated rates paid by most commercial insurers. While the hospital's negotiated rates range from $79 to $3,254 depending on the payer, the cash price is notably lower than the median negotiated amount of $1,464 for this specific service. It is important to note that cash-pay can sometimes be the most economical option for patients with high-deductible plans, as the insurance negotiated rate often exceeds the cash price. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative costs associated with insurance billing.
When evaluating the cost relative to federal standards, the Medicare benchmark for this procedure is $243.77, which serves as the objective baseline for evaluating hospital pricing markup. The facility's cash rate of $1,952 represents a significant markup compared to the Medicare amount, consistent with commercial pricing structures that average 200% to 300% of Medicare rates. Commercial negotiated rates for this service vary widely across payers, with some plans like Medicaid/KanCare having a low of $79 and others like Transplants-Case Rates reaching a high of $3,254. Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, it is crucial to request an itemized bill to identify any errors or unbundled codes before finalizing payment.