Ultrasound, leg veins (duplex)
Facility: Kansas City Orthopaedic Institute
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $957
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.93x 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 393% of the Medicare baseline (a markup of 293%). 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 | $217 | 89% |
| Aetna | $217 | 89% |
| Cigna | $227 - $1,368 | 93% |
| Blue Cross Blue Shield | $957 - $1,751 | 393% |
| Medica | $1,504 | 617% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $217 to $1,751 depending on the insurance carrier. While UnitedHealthcare and Aetna have a consistent negotiated rate of $217, Cigna rates vary between $227 and $1,368, and Blue Cross Blue Shield rates span $957 to $1,751 across six plans. It is important to note that cash payments are not listed for this procedure, so patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling. Since commercial negotiated rates often include administrative overhead and can exceed the true cost of care, patients with high-deductible plans should confirm whether paying out-of-pocket might be more affordable than using insurance, especially if their deductible has not yet been met.
The Medicare benchmark for this service is $243.77, which serves as a baseline for evaluating the facility's pricing. The median negotiated rate of $957 is significantly higher than the Medicare amount, reflecting the typical markup found in commercial contracts where rates average 200% to 300% of Medicare. To ensure you are receiving fair pricing, it is recommended to request an itemized billing audit rather than accepting a summary bill, as hospitals may obscure individual charges or unbundled codes. Additionally, if you receive a balance bill for services not covered by your plan or services rendered by out-of-network providers, you have the right to dispute the amount under the No Surprises Act, rather than paying immediately out of fear of credit damage.