Ultrasound, leg veins (duplex)
Facility: Grisell Memorial Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $785
- Cash Discount Price: $855
- vs. Medicare Baseline: 3.22x 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 322% of the Medicare baseline (a markup of 222%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $452 | 185% |
| UnitedHealthcare | $670 - $900 | 275% |
| Medicaid / KanCare | $900 | 369% |
| Humana | $900 | 369% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Grisell Memorial Hospital in Ransom, Kansas, the facility's cash median price of $855.00 is lower than the state average, which is $900.00. While the hospital is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance negotiated rate. Although UnitedHealthcare negotiates a rate up to $900.00, the cash option could result in lower out-of-pocket costs if the patient's deductible has not yet been met. It is important to note that commercial rates often include administrative overhead and contract dynamics that can make them higher than direct cash payments, so verifying the specific "self-pay" or "prompt-pay" discount available before scheduling is recommended.
The Medicare benchmark for this service is $243.77, which serves as a baseline for evaluating the facility's pricing markup. The facility's cash price of $855.00 represents a significant increase over the Medicare rate, a common occurrence in commercial billing where rates can average 200% to 300% of Medicare amounts. If you choose to use insurance, be aware that the allowed amount varies by payer, ranging from $452.00 for Blue Cross Blue Shield plans to $900.00 for Medicaid/KanCare. If you receive a bill that includes charges for services not rendered or unbundled components, you should request a full itemized audit before paying, as over 80% of hospital bills contain errors. Always dispute any balance billing or unexpected charges in writing to