Ultrasound, leg veins (duplex)
Facility: Ellsworth County Medical Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $591
- Cash Discount Price: $891
- 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 |
|---|---|---|
| Va Ccn-All Plans | $285 - $552 | 117% |
| Humana | $285 - $1,116 | 117% |
| Triwest -All Plans | $285 - $552 | 117% |
| Healthy Blue Mcr Adv | $285 - $552 | 117% |
| UnitedHealthcare | $394 - $1,175 | 162% |
| Blue Cross Blue Shield | $452 - $476 | 185% |
| Aetna | $545 - $1,058 | 224% |
| First Health - All Plans | $545 - $1,058 | 224% |
| Cigna | $576 - $1,116 | 236% |
| Healthy Blue Mcaid- All Other Plans | $606 - $1,175 | 249% |
| Medicaid / KanCare | $606 - $1,175 | 249% |
| Coventry Mcaid-All Plans | $606 - $1,175 | 249% |
| Providers Care-Wppa-All Plans | $909 - $1,762 | 373% |
Consumer Guidance & Cost Commentary
For this ultrasound of the leg veins at Ellsworth County Medical Center, the cash price is $891.00, which matches the facility's cash median. This rate is significantly higher than the state average for this procedure, which is $243.77 (Medicare amount). While commercial insurance plans negotiate rates that typically cap between $285 and $1,175 depending on the carrier, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. For patients with high-deductible plans, paying the cash price of $891.00 upfront may be more cost-effective than relying on insurance, as the insurer's allowed amount could result in a higher out-of-pocket balance if the deductible is not yet met.
To minimize costs, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill by 20% to 50% by bypassing insurance claims processing. It is also important to avoid balance billing by ensuring the facility is in-network for your plan, as the No Surprises Act protects against unexpected bills for emergency care and non-emergency services at in-network facilities. If you receive a bill, request a full itemized statement to verify that all charges are accurate and that no services were unbundled or rendered incorrectly, as over 80% of hospital bills contain errors that can be corrected through a formal written audit.