Ultrasound, leg veins (duplex)
Facility: Holton Community Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $649
- Cash Discount Price: $677
- vs. Medicare Baseline: 2.66x 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 266% of the Medicare baseline (a markup of 166%). 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 |
|---|---|---|
| UnitedHealthcare | $382 - $1,085 | 157% |
| Aetna | $382 - $1,085 | 157% |
| Humana | $386 - $581 | 158% |
| Kansas Superior Select - All Plans | $390 - $587 | 160% |
| Blue Cross Blue Shield | $476 | 195% |
| Preferred Health Freedom | $598 - $901 | 245% |
| Preferred Health Professionals | $598 - $901 | 245% |
| Preferred Health Fn Select - All Other Plans | $598 - $901 | 245% |
| Wppa Providers - All Plans | $685 - $1,031 | 281% |
| Medicaid / KanCare | $721 - $1,085 | 296% |
Consumer Guidance & Cost Commentary
For the CPT code 93970 (Ultrasound, leg veins), Holton Community Hospital in Holton, KS, lists a cash median price of $677.00, which is notably higher than the facility's own negotiated rate of $598.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if their plan's negotiated rate exceeds the cash price. The data shows a wide variance in allowed amounts across payers, ranging from a low of $382 to a high of $1,085, with Medicaid/KanCare having a median allowed amount of $721. Given that the facility's cash rate is significantly lower than the gross charge of $903.00, patients with high-deductible plans may find paying out-of-pocket directly to the hospital reduces their overall out-of-pocket costs compared to facing a higher insurance allowed amount.
To ensure you are receiving the most accurate pricing, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. While the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still verify their specific plan details to avoid unexpected charges. Additionally, patients should inquire about prompt-pay discounts or self-pay rates before scheduling, as these upfront incentives can lower the total cost by bypassing administrative claim processing fees. Always confirm the exact classification of your visit and request a written waiver of insurance submission if