Ultrasound, leg veins (duplex)
Facility: Great Plains Of Sabetha
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $622
- Cash Discount Price: $655
- vs. Medicare Baseline: 2.55x 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 255% of the Medicare baseline (a markup of 155%). 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 |
|---|---|---|
| Celtic Mcr Adv | $341 | 140% |
| Aetna | $344 - $662 | 141% |
| Celtic Comm Exchange-All Other Plans | $426 | 175% |
| Great West Healthcare-All Plans | $557 | 228% |
| UnitedHealthcare | $609 - $655 | 250% |
| Multiplan-Phcs-All Plans | $622 | 255% |
| Cigna | $622 | 255% |
| Humana | $622 | 255% |
| Century/Wppa/Providers-All Plans | $622 | 255% |
| Federated Mutual Ins-All Plans | $629 | 258% |
| Medicaid / KanCare | $655 | 269% |
| Blue Cross Blue Shield | $655 | 269% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Great Plains Of Sabetha in Sabetha, Kansas, the cash price is $655.00, which matches the facility's negotiated rate with Medicaid/KanCare and Blue Cross Blue Shield. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $344 to $655, the cash price remains consistent at $655.00. This suggests that for patients with high-deductible plans or those without insurance, paying the cash price directly may be more cost-effective than relying on insurance, as the negotiated rates for some commercial plans exceed the cash amount. Patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket could avoid the administrative costs and potential higher negotiated rates associated with insurance claims.
To ensure you are receiving the most accurate billing, it is important to request an itemized bill that lists every specific CPT code and service rendered, rather than accepting a summary invoice that may obscure errors or unbundled charges. If you receive a balance bill for the difference between the provider's full charge and your insurance allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Additionally, you can often reduce your final cost by asking the hospital about prompt-pay discounts, which typically offer a fee reduction for upfront payment, bypassing the costly insurance claims processing cycle. Always dispute any unexpected bills in writing to protect your rights and ensure all charges are accurate.