Ultrasound, leg veins (duplex)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $631
- Cash Discount Price: $665
- vs. Medicare Baseline: 2.59x 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 259% of the Medicare baseline (a markup of 159%). 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 | $532 | 218% |
| Humana | $605 | 248% |
| Aetna | $615 - $665 | 252% |
| UnitedHealthcare | $631 | 259% |
| Hpk-All Plans | $631 | 259% |
| Medicaid / KanCare | $665 | 273% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $665.00, which matches the facility's gross charge and the median cash rate. This amount is significantly higher than the state average, reflecting the facility's status as a Critical Access Hospital owned by a Government Hospital District. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $605 to $665, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as doing so avoids the administrative overhead and potential higher negotiated fees charged to insured members.
To minimize unexpected costs, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the bill by 20% to 50% by bypassing insurance claims processing. It is also important to request a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If a balance bill arises from an out-of-network provider, patients should not pay immediately but instead dispute the charge with their insurer to invoke federal protections under the No Surprises Act.