Ultrasound, leg veins (duplex)
Facility: Hiawatha Community Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $1,032
- Cash Discount Price: $1,325
- vs. Medicare Baseline: 4.23x 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 423% of the Medicare baseline (a markup of 323%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $457 - $481 | 187% |
| Aetna | $490 - $1,071 | 201% |
| UnitedHealthcare | $490 - $1,138 | 201% |
| Humana | $495 | 203% |
| Ambetter / Centene | $588 | 241% |
| Oscar - All Plans | $994 | 408% |
| Centrus Health Direct - All Plans | $994 | 408% |
| Preferred Hlth - All Plans | $1,192 | 489% |
| Wppa Providrs Care - All Plans | $1,259 | 516% |
| Cigna | $1,259 | 516% |
| Multiplan - All Plans | $1,285 | 527% |
| Midlands Choice - All Plans | $1,285 | 527% |
| Healthy Blue Mcaid - All Plans | $1,325 | 544% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $1,325.00, which matches the facility's cash median. While insurance negotiated rates for this service range from $457 to $1,325 depending on the plan, patients with high-deductible plans might find the cash price more affordable if their insurance allows a higher negotiated rate than the cash charge. It is important to note that the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, and while the cash rate is the same as the Medicare amount of $243.77, commercial negotiated rates often exceed this baseline due to administrative costs and contract dynamics.
Before scheduling, patients should verify their specific plan's allowed amount, as some insurers may negotiate rates higher than the cash price, making out-of-pocket payment a better financial choice. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims processing cycle. If a patient receives a bill after using insurance, they should request a full itemized CPT-coded statement to identify any errors, double-billing, or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.