Ultrasound, leg veins (duplex)
Facility: Greenwood County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $663
- Cash Discount Price: $628
- vs. Medicare Baseline: 2.72x 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 272% of the Medicare baseline (a markup of 172%). 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 |
|---|---|---|
| Triwest - All Plans | $280 | 115% |
| UnitedHealthcare | $330 - $659 | 135% |
| Choicecare Mcr Adv - All Plans | $330 | 135% |
| Tricare | $330 | 135% |
| Blue Cross Blue Shield | $452 - $476 | 185% |
| Integrated Health Plan - All Plans | $589 | 242% |
| First Health - All Other Plans | $667 | 274% |
| First Health Ccn Network | $667 | 274% |
| Beech Street - All Plans | $667 | 274% |
| Preferred Hs (Coventry) - All Plans | $706 | 290% |
| Principal Health Care Inc - All Plans | $746 | 306% |
| Amerigroup Mcaid-All Plans | $785 | 322% |
| Medicaid / KanCare | $785 | 322% |
| Providrs Care/Wppa - All Plans | $1,178 | 483% |
Consumer Guidance & Cost Commentary
For this ultrasound of the leg veins (duplex) at Greenwood County Hospital in Eureka, Kansas, the facility's cash price is $628, which is lower than the median negotiated rate of $659 paid by UnitedHealthcare and the median allowed amount of $663. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial insurance rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan, paying the cash price of $628 upfront may result in significant savings compared to your insurance paying its negotiated rate of $659, especially if your deductible has not yet been met. Always ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce the final cost.
The facility's gross charge of $785 is significantly higher than the cash price, and while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify your specific plan's network status. Commercial payers like Amerigroup and Medicaid/KanCare are billed the full gross amount of $785, whereas out-of-network scenarios could theoretically lead to unexpected bills, though federal protections often prevent this for emergency care. To ensure you are receiving fair pricing, request an itemized bill that breaks down every CPT code and charge, as summary bills can obscure errors or unbundled services. Comparing this rate to the Medicare benchmark of $243.77 reveals a substantial markup, highlighting the importance of understanding whether your commercial rate aligns with fair pricing standards rather than the inflated chargemaster list.