Ultrasound, leg veins (duplex)
Facility: Lane County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $1,486
- Cash Discount Price: $1,486
- vs. Medicare Baseline: 6.10x 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 610% of the Medicare baseline (a markup of 510%). 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 |
|---|---|---|
| Aetna | $1,337 - $1,412 | 548% |
| UnitedHealthcare | $1,337 - $1,486 | 548% |
| Healthy Blue Mcr Adv - All Other Plans | $1,486 | 610% |
| Medicaid / KanCare | $1,486 - $1,635 | 610% |
| Healthy Blue Mcaid | $1,486 | 610% |
| Wppa Providers-All Plans | $2,229 | 914% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Lane County Hospital in Dighton, KS, the cash price is $1,486.00, which matches the facility's negotiated rate for UnitedHealthcare and Healthy Blue. This cash price is significantly higher than the Medicare benchmark of $243.77, indicating a markup typical of commercial pricing structures. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should be aware that paying cash upfront can sometimes be more cost-effective than relying on insurance, particularly if their plan has a high deductible or if the insurer's negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to confirm if self-pay or prompt-pay discounts are available before scheduling, as these incentives can reduce the final amount owed.
The data shows that while the cash rate is $1,486.00, Medicaid/KanCare plans may pay up to $1,635.00 for this service, suggesting that commercial cash rates are competitive or lower than certain public insurance payments. However, because the Medicare rate serves as the objective baseline for fair pricing, the commercial charge represents a substantial increase over the federal standard. Consumers should avoid accepting summary bills without requesting a detailed, itemized statement to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain mistakes. If a balance bill arises from an out-of-network service, patients should not pay immediately but instead dispute the charge with their insurer to verify compliance with federal protections like the No Surprises Act.