Ultrasound, leg veins (duplex)
Facility: Clara Barton Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $1,040
- Cash Discount Price: $809
- vs. Medicare Baseline: 4.27x 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 427% of the Medicare baseline (a markup of 327%). 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 | $476 | 195% |
| 6 Degrees Health - All Plans | $809 | 332% |
| Wppa-All Plans | $925 | 379% |
| UnitedHealthcare | $1,040 | 427% |
| Aetna | $1,040 | 427% |
| Phcs - All Plans | $1,040 | 427% |
| Hlth Partners Of Ks-All Plans | $1,064 | 436% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Clara Barton Hospital in Hoisington, KS, the cash price is $809.00, which is significantly lower than the facility's negotiated rates of $1,040.00 and the highest commercial payer rate of $1,064.00. While the facility's cash rate is lower than the state average, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds the cash price. It is important to note that the Medicare benchmark for this service is $243.77, providing a clear baseline for evaluating the facility's pricing markup; commercial rates often average 200% to 300% of this amount, whereas fair pricing is typically defined as 120% to 150%.
To minimize costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payment and bypass costly insurance billing cycles. Since over 80% of hospital bills contain errors, consumers are advised to request a detailed, itemized statement before paying to identify any unbundled codes or services not rendered. Additionally, under the No Surprises Act, patients are protected from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, so they should not feel pressured to pay surprise bills immediately without disputing the charge or requesting an audit.