Ultrasound, leg veins (duplex)
Facility: Mercy Hospital Columbus
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $839
- Cash Discount Price: $751
- vs. Medicare Baseline: 3.44x 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 344% of the Medicare baseline (a markup of 244%). 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 |
|---|---|---|
| Humana | $158 - $1,098 | 65% |
| Medicaid / KanCare | $158 - $839 | 65% |
| Blue Cross Blue Shield | $206 - $839 | 85% |
| UnitedHealthcare | $206 - $959 | 85% |
| Medicare (plans) | $226 - $873 | 93% |
| Insurance System Inc Contracted [320465] | $497 | 204% |
| Health Systems Inc Contracted [320174] | $497 | 204% |
| Administrative Payor Contracted [320005] | $520 | 213% |
| Mercy Mgd Behavioral Health Contracted [320259] | $839 | 344% |
| Halo Hcr Inc Hospice Contracted [320432] | $839 | 344% |
| Novasys Contracted [320285] | $839 | 344% |
| Qual Choice Contracted [320325] | $839 | 344% |
| Globalhealth Contracted [320145] | $839 | 344% |
| Provider Partners Health Plans Contracted [320450] | $839 | 344% |
| Kindful Hospice Contracted [320434] | $839 | 344% |
| Mercy Hospice Okc [20252] | $839 | 344% |
| Centurion Of Missouri [20459] | $839 | 344% |
| Aetna | $839 - $1,040 | 344% |
| Cherokee Nation Health Serv Contracted [320066] | $839 | 344% |
| Home State Health Plan Contracted [320187] | $839 | 344% |
| Kindful Hospice [20434] | $839 | 344% |
| Elara Caring Aspire Hospice [20433] | $839 | 344% |
| Cross Timbers Hospice [20098] | $839 | 344% |
| Ambetter / Centene | $839 | 344% |
| Dept Of Veteran Affairs Contracted [320106] | $839 | 344% |
| Pace Of The Ozarks Contracted [320518] | $839 | 344% |
| Cigna | $839 | 344% |
| Halo Hcr Inc Hospice [20432] | $839 | 344% |
| Medical Associates Health Contracted [320444] | $839 | 344% |
| Indian Health Service Contracted [320198] | $839 | 344% |
| Tricare | $842 | 345% |
| Healthscope Contracted [320182] | $891 | 366% |
| Workers Comp [20426] | $925 - $983 | 379% |
| United Medical Resources Contracted [320454] | $959 - $1,098 | 393% |
| Medica Contracted [320239] | $1,036 | 425% |
| Healthlink Contracted [320179] | $1,040 - $1,098 | 427% |
| Usa Managed Care Org Contracted [320429] | $1,040 | 427% |
| American Healthcare Alliance Contracted [320020] | $1,040 | 427% |
| Mercy Benefit Admin Contracted [320251] | $1,040 - $1,098 | 427% |
| First Health Contracted [320128] | $1,040 | 427% |
| Federal Medical Center Contracted [320127] | $1,040 | 427% |
| Preferred Health Plan Contracted [320522] | $1,040 | 427% |
| Yuzu Health Contracted [320521] | $1,098 | 450% |
| Imagine 360 Contracted [320494] | $1,098 | 450% |
| Ebms Contracted [320493] | $1,098 | 450% |
| Private Health Care Systems Contracted [320320] | $1,098 | 450% |
| Benefit Management Contracted [320052] | $1,098 | 450% |
| Ppo Plus Contracted [320310] | $1,098 | 450% |
| Edison Health Solutions Contracted [320502] | $1,098 | 450% |
| Aither Health Contracted [320449] | $1,098 | 450% |
| 90 Degree Benefits Contracted [320436] | $1,098 | 450% |
| Reflect Health Contracted [320492] | $1,098 | 450% |
| Auxiant Contracted [320462] | $1,098 | 450% |
| Show-Me Health Administrators Contracted [320483] | $1,098 | 450% |
| Point C Contracted [320238] | $1,098 | 450% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Mercy Hospital Columbus, the facility's cash price of $751.00 is lower than the median negotiated rate of $839.00 paid by most insurance plans, including Humana, Medicaid/KanCare, and Blue Cross Blue Shield. While the facility's cash rate is also below the gross charge of $1,156.00, patients with high-deductible plans may find paying cash upfront more cost-effective than relying on insurance, which often results in higher allowed amounts due to administrative overhead and contract structures. It is important to note that many of the 56 payers listed, such as UnitedHealthcare and Aetna, have negotiated rates ranging from $839 to $1,098, meaning the cash price represents a significant discount compared to standard insurance reimbursement.
Patients should verify their specific plan details before scheduling, as some commercial payers may have negotiated rates that exceed the facility's cash price, particularly for out-of-network scenarios where balance billing could occur. Although the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in-network facilities, it is advisable to request a prompt-pay discount or self-pay rate directly from the hospital prior to receiving services to ensure the lowest possible cost. Additionally, if a bill is received, consumers should request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as these are common sources of unnecessary medical debt.