Ultrasound, leg veins (duplex)
Facility: Graham County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $490
- Cash Discount Price: $630
- vs. Medicare Baseline: 2.01x 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 201% of the Medicare baseline (a markup of 101%). 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 |
|---|---|---|
| Medicaid / KanCare | $317 | 130% |
| UnitedHealthcare | $317 - $598 | 130% |
| Medicare (plans) | $472 | 194% |
| Blue Cross Blue Shield | $476 | 195% |
| Celtic Commercial-All Other Plans | $520 | 213% |
| Wppa (Providers Care)-All Plans | $598 | 245% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Graham County Hospital in Hill City, Kansas, the cash price is $630, which matches the state average for this service. While commercial insurance plans like UnitedHealthcare and Celtic Commercial typically pay negotiated rates ranging from $317 to $598, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the $630 cash rate directly, as this can be lower than the negotiated amount their insurer would allow. It is important to verify the specific allowed amount for your plan before scheduling, as in-network rates vary significantly even within the same facility.
The facility's negotiated rate of $490 sits below the gross charge of $630, reflecting standard contract dynamics where insurers cap payments to protect members. However, the median amount paid by payers was $520, indicating that some plans may receive higher reimbursement depending on their specific tier. Since this is a Critical Access Hospital, patients should proactively ask about "self-pay" or "prompt-pay" discounts before check-in, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, because Medicare sets the benchmark at $243.77 for this procedure, the commercial negotiated rates represent a markup above the federal cost baseline, highlighting the value of comparing your specific plan's allowed amount against the cash price to minimize out-of-pocket expenses.