Ultrasound, leg veins (duplex)
Facility: Wamego Health Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $144
- Cash Discount Price: $274
- vs. Medicare Baseline: 0.59x 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.
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 |
|---|---|---|
| UnitedHealthcare | $38 - $198 | 16% |
| Aetna | $39 - $206 | 16% |
| Medicaid / KanCare | $39 - $206 | 16% |
| Providrs Care | $40 - $229 | 16% |
| Tricare | $155 | 64% |
| Blue Cross Blue Shield | $631 - $665 | 259% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure for leg veins (duplex) at Wamego Health Center in Wamego, KS, the cash price is $274.00, which is significantly lower than the facility's gross charge of $685.00. While commercial payers like UnitedHealthcare, Aetna, and Medicaid/KanCare have negotiated rates ranging from $38 to $229, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that the facility's cash rate is roughly 1.13 times the Medicare benchmark of $243.77, which serves as a reliable baseline for evaluating fair pricing. Additionally, the median negotiated rate across all payers is $144.00, suggesting that while insurance contracts exist, the cash option remains the most cost-effective choice for self-pay patients.
Patients should be aware that balance billing could occur if they receive care from out-of-network providers, where the hospital bills the difference between the full charge and the insurance allowed amount, though the No Surprises Act protects against this for emergency services at in-network facilities. To ensure you are not overcharged, always request a detailed, itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. If you choose to pay directly, ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the cost by bypassing administrative fees associated with insurance claims processing.