Ultrasound, leg veins (duplex)
Facility: Hamilton County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $589
- Cash Discount Price: $654
- vs. Medicare Baseline: 2.42x 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 242% of the Medicare baseline (a markup of 142%). 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 | $226 - $481 | 93% |
| First Health Coventry - All Plans | $556 | 228% |
| Cigna | $621 | 255% |
| UnitedHealthcare | $621 | 255% |
| Va Ccn - All Plans | $654 | 268% |
| Aetna | $1,112 | 456% |
Consumer Guidance & Cost Commentary
For this ultrasound of the leg veins at Hamilton County Hospital in Syracuse, KS, the cash price is $654, which matches the facility's median negotiated rate. While the hospital is a Critical Access Hospital with government local ownership, the cash price exceeds the state average for this procedure, meaning patients paying out-of-pocket may be paying more than the typical rate in Kansas. However, for individuals with high-deductible plans, paying the cash price of $654 upfront could be more cost-effective than relying on insurance, as the facility's negotiated rates for major payers like Aetna and UnitedHealthcare reach $1,112 and $654 respectively, often exceeding the cash amount. Patients should verify if their specific plan has a deductible that would make the insurance allowed amount lower than the cash price before scheduling.
To avoid unexpected costs, consumers should request a prompt-pay discount before check-in, as paying in full upfront can sometimes reduce the bill by 20% to 50%. Additionally, if you are using insurance, ensure you receive an itemized bill rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you encounter a balance bill from an out-of-network provider at this in-network facility, remember that the No Surprises Act protects you from being billed for the difference between the provider's full charge and your insurance allowed amount for emergency or non-emergency services. Always dispute any surprise bills in writing and request a formal audit to ensure accuracy.