Ultrasound, leg veins (duplex)
Facility: Kiowa District Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $633
- Cash Discount Price: $536
- vs. Medicare Baseline: 2.60x 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 260% of the Medicare baseline (a markup of 160%). 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 |
|---|---|---|
| Tricare | $261 | 107% |
| Healthchoice-All Plans | $396 | 162% |
| Blue Cross Blue Shield | $476 | 195% |
| UnitedHealthcare | $536 - $670 | 220% |
| Health Partners Of Ks-All Plans | $590 | 242% |
| Humana | $605 | 248% |
| Multiplan-All Plans | $630 | 258% |
| Gbs Insurance - All Plans | $630 | 258% |
| Medicare (plans) | $636 | 261% |
| Triwest-All Plans | $636 | 261% |
| Aetna | $636 | 261% |
| Medicaid / KanCare | $670 | 275% |
| Providers Care (Wppa)-All Plans | $1,005 | 412% |
| Liberty Healthshare-All Plans | $1,082 | 444% |
Consumer Guidance & Cost Commentary
For the CPT code 93970, representing an ultrasound of leg veins, Kiowa District Hospital in Kiowa, KS, has a cash median price of $536.00, which is lower than the facility's negotiated median paid rate of $630.00. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare has a range of $536 to $670, while Providers Care (Wppa) charges $1,005, illustrating how in-network rates can vary significantly. If you have a high-deductible plan, paying the cash price of $536.00 upfront might result in immediate savings compared to your insurance's negotiated rate, provided you have not yet met your deductible. We recommend contacting the hospital directly to confirm if they offer self-pay or prompt-pay discounts, which can further reduce the final amount owed.
To ensure you are receiving fair pricing, it is important to compare these rates against the Medicare benchmark, which serves as a scientifically validated baseline for healthcare costs. In this case, the Medicare amount for this service is $243.77, and the facility's negotiated rate of $633.00 represents a markup relative to this federal standard. Commercial rates often average between 200% and 300% of the Medicare rate, though fair pricing is typically defined as 120% to 150%. If you receive an itemized bill, review it carefully to check for errors such as code unbundling