Ultrasound, leg veins (duplex)
Facility: Rooks County Health Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $917
- Cash Discount Price: $764
- vs. Medicare Baseline: 3.76x 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 376% of the Medicare baseline (a markup of 276%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $479 | 196% |
| Celtic Mcr Adv | $479 | 196% |
| Tricare | $479 | 196% |
| Blue Cross Blue Shield | $481 | 197% |
| Celtic Comm - All Other Plans | $527 | 216% |
| UnitedHealthcare | $917 | 376% |
| Preferred Benefits Admin | $917 | 376% |
| Aetna | $917 | 376% |
| Preferred Hlthcare - All Other Plans | $968 | 397% |
| Health Partners - All Plans | $968 | 397% |
| Healthy Blue Mcaid - All Plans | $1,019 | 418% |
Consumer Guidance & Cost Commentary
For the CPT code 93970, representing an ultrasound of leg veins, Rooks County Health Center in Plainville, KS, lists a gross charge of $1,019. While the facility's cash median rate is $764, the negotiated rates for commercial payers range from $479 to $968, with the median negotiated amount being $917. It is important to note that Medicare serves as the objective baseline for pricing, with a benchmark rate of $243.77 for this procedure. Commercial rates often exceed the cash price due to administrative costs and contract structures; in this case, the cash rate of $764 is significantly lower than the median negotiated rate of $917, which may be beneficial for patients with high-deductible plans who have not yet met their out-of-pocket maximum.
Patients should verify their specific plan details before scheduling, as the lowest negotiated rate in this dataset is $479, while the highest is $1,019. Although the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide a specific county or state average for comparison. To minimize costs, individuals should inquire directly with the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, if you have insurance, ensure you understand your deductible status, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket expenses than paying the cash rate directly.