Ultrasound, leg veins (duplex)
Facility: Stafford County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $686
- Cash Discount Price: $686
- vs. Medicare Baseline: 2.81x 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 281% of the Medicare baseline (a markup of 181%). 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 |
|---|---|---|
| Health Partners-All Plans | $652 | 267% |
| Medica Mcr- All Plans | $686 | 281% |
| Humana | $686 | 281% |
| UnitedHealthcare | $686 | 281% |
| Va Ccn-All Plans | $686 | 281% |
Consumer Guidance & Cost Commentary
For the CPT code 93970, representing an ultrasound of leg veins, the cash and negotiated rates at Stafford County Hospital are both $686. This amount matches the facility's cash median and is identical to the negotiated rates across all five payers, including Health Partners, Medica, Humana, UnitedHealthcare, and the VA. The facility is a Critical Access Hospital in Stafford, Kansas, and its rates are significantly higher than the Medicare benchmark of $243.77, reflecting a markup of 2.8 times the federal baseline. While commercial rates often average 200% to 300% of Medicare, this specific service shows a fixed price that exceeds the government rate, which is common for specialized diagnostic imaging where administrative costs and provider work are factored into the contract.
Patients should be aware that cash payments can sometimes be more cost-effective than using insurance if the deductible has not been met, as the negotiated rate here is already set at the cash price of $686. Since the facility is a government-owned Critical Access Hospital, it may offer self-pay or prompt-pay discounts that could further reduce the final amount owed. To ensure you are receiving the best possible rate, it is recommended to explicitly request a "self-pay" classification before scheduling the procedure and to ask about any prompt-pay incentives for upfront payment. Additionally, if you receive an itemized bill, review it carefully to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.