Ultrasound, leg veins (duplex)
Facility: Stevens County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $703
- Cash Discount Price: $808
- vs. Medicare Baseline: 2.88x 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 288% of the Medicare baseline (a markup of 188%). 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 |
|---|---|---|
| Humana | $299 | 123% |
| Aetna | $308 - $808 | 126% |
| Blue Cross Blue Shield | $457 - $481 | 187% |
| First Health - All Plans | $727 | 298% |
| Wppa - All Plans | $768 | 315% |
| Medicaid / KanCare | $808 | 331% |
Consumer Guidance & Cost Commentary
For this ultrasound of leg veins at Stevens County Hospital in Hugoton, Kansas, the cash price is $808, which matches the facility's gross chargemaster rate. While the hospital is a Critical Access Hospital owned by the local government, the cash rate is significantly higher than the state average for this procedure. Commercial insurance plans typically pay less than the cash price; for example, Aetna's negotiated rate ranges from $308 to $808, and Blue Cross Blue Shield's range is $457 to $481. This price structure highlights a common billing dynamic where cash payments can sometimes be more cost-effective for patients with high-deductible plans, as the insurance negotiated rate may exceed the cash price. However, patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs than paying directly.
The Medicare benchmark for this service is $243.77, which serves as a critical baseline for evaluating the facility's pricing markup. The hospital's cash rate of $808 represents a substantial increase over the Medicare amount, illustrating how commercial rates often include administrative overhead and profit margins not reflected in federal reimbursement. To minimize potential costs, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, if you have received a bill from this facility, it is advisable to request a detailed, itemized statement rather than accepting a summary invoice. This audit can help identify errors such as unbundled codes or services not rendered, ensuring that the final amount reflects only the care