Ultrasound, leg veins (duplex)
Facility: F W Huston Medical Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $1,043
- Cash Discount Price: $1,084
- vs. Medicare Baseline: 4.28x 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 428% of the Medicare baseline (a markup of 328%). 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 | $481 | 197% |
| Aetna | $1,016 | 417% |
| Humana | $1,070 | 439% |
| Cigna | $1,152 | 473% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at F W Huston Medical Center in Winchester, KS, the facility's cash price of $1,084 is lower than the median negotiated rates paid by major insurers like Aetna ($1,016) and Humana ($1,070). This suggests that patients with high-deductible plans or those without insurance might save money by paying cash directly, provided they confirm the facility offers a "self-pay" or "prompt-pay" discount that could further reduce the cost. It is important to note that while the facility is a Critical Access Hospital, the cash rate does not automatically guarantee the lowest possible price; patients should explicitly ask the billing department about any upfront payment incentives before scheduling to ensure they are not locked into a higher insurance-driven rate.
The facility's gross charge of $1,355 is significantly higher than the Medicare benchmark of $243.77, illustrating the common markup found in commercial billing structures. Under the No Surprises Act, patients should be aware that if they are treated by an out-of-network provider at this in-network facility, they are protected from balance billing for emergency and non-emergency services, though they should still request an itemized bill to verify that no unbundled codes or services not rendered have been charged. Since over 80% of hospital bills contain errors, patients should review their statement line-by-line to catch any double-billing or unnecessary fees before making a payment, ensuring they are only paying for the actual services received.