Ultrasound, leg veins (duplex)
Facility: Kansas Heart Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $272
- Cash Discount Price: $366
- vs. Medicare Baseline: 1.12x 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 |
|---|---|---|
| Wppa - All Plans | $40 - $272 | 16% |
| Multiplan - All Plans | $90 - $613 | 37% |
| Aetna | $98 - $681 | 40% |
| Soonerselect Mcaid - All Plans | $100 - $681 | 41% |
| Medicaid / KanCare | $100 - $681 | 41% |
| Celtic Mcaid - All Other Plans | $100 - $681 | 41% |
| Blue Cross Blue Shield | $100 - $681 | 41% |
| UnitedHealthcare | $100 - $681 | 41% |
| Tricare | $198 | 81% |
| Celtic Mcr Adv | $220 | 90% |
| Humana | $220 | 90% |
Consumer Guidance & Cost Commentary
For the CPT code 93970, representing an ultrasound of leg veins, Kansas Heart Hospital in Wichita, KS, has a gross charge of $581.00. While the facility's cash median rate is $366.00, which is lower than the gross charge, commercial insurance negotiated rates vary significantly by payer, ranging from a low of $40 to a high of $681.00. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; therefore, patients with high-deductible plans or those who have not yet met their deductible may find paying the cash rate directly more cost-effective than relying on insurance, which could result in higher out-of-pocket expenses if the negotiated allowed amount is substantial.
To ensure you are receiving the most accurate pricing, it is recommended to request an itemized billing audit before finalizing payment, as summary bills can obscure individual charges and potential errors. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed by 20% to 50% if paid in full upfront. While the facility's facility rating is 4 out of 5, the primary focus for consumers should remain on verifying the specific allowed amount with their insurance carrier and comparing it against the cash price to determine the most financially prudent option for their specific situation.