Ultrasound, leg veins (duplex)
Facility: Kiowa County Memorial Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $592
- Cash Discount Price: $565
- vs. Medicare Baseline: 2.43x 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 243% of the Medicare baseline (a markup of 143%). 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 | $481 - $592 | 197% |
| UnitedHealthcare | $533 - $665 | 219% |
| Health Partners Of Ks-All Plans | $585 | 240% |
| Celtic Comml Exchange-All Other Plans | $592 | 243% |
| Aetna | $592 | 243% |
| Humana | $592 | 243% |
| Medica Prime Mcare Cost-All Plans | $592 | 243% |
| Medicaid / KanCare | $665 | 273% |
| Providrs Care/Wppa-All Plans | $998 | 409% |
Consumer Guidance & Cost Commentary
For the CPT code 93970 (Ultrasound, leg veins), Kiowa County Memorial Hospital in Greensburg, KS, lists a gross charge of $665.00. While the facility's cash median rate is $565.00, the negotiated rates for in-network payers range from $533 to $998, with Medicaid/KanCare at $665.00. It is important to note that cash payments can sometimes be more cost-effective than using insurance, particularly for patients with high-deductible plans where the insurer's negotiated rate might exceed the cash price. Patients should contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can significantly reduce the final amount owed.
This procedure's pricing should be evaluated against the Medicare benchmark of $243.77, which serves as a scientifically validated baseline for the true cost of care. The facility's gross charge is 2.4 times the Medicare rate, a common markup in the healthcare industry. If you receive a bill, ensure you are reviewing an itemized statement that breaks down every CPT code and service to avoid errors such as double-billing or unbundled charges. If you encounter a balance bill from an out-of-network provider at an in-network facility, you may be protected under the No Surprises Act, which prohibits balance billing for emergency and non-emergency services; in such cases, you should dispute the bill in writing rather than paying immediately to avoid unexpected costs.