Ultrasound, leg veins (duplex)
Facility: Wilson Medical Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $1,278
- Cash Discount Price: $1,198
- vs. Medicare Baseline: 5.24x 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 524% of the Medicare baseline (a markup of 424%). 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 | $476 - $1,597 | 195% |
| Ambetter / Centene | $846 - $1,597 | 347% |
| UnitedHealthcare | $846 - $1,485 | 347% |
| Tricare | $846 | 347% |
| Aetna | $846 - $1,597 | 347% |
| Humana | $846 | 347% |
| Cigna | $1,278 | 524% |
| Health Partners-All Plans | $1,469 | 603% |
| Mulitplan-All Plans | $1,469 | 603% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Wilson Medical Center in Neodesha, KS, the facility's cash price of $1,198 is notably higher than the state average, which is $931. While commercial insurance plans like Blue Cross Blue Shield and Aetna negotiate rates up to the gross charge of $1,597, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated ceiling can be significantly higher than the self-pay amount. To maximize savings, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if settled upfront, bypassing the costly claims processing cycle that inflates insurance rates.
When evaluating the cost of this service, it is important to compare the facility's pricing against the federal Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this procedure is $243.77, and the facility's cash rate represents a markup of 5.2 times the Medicare amount, which is consistent with the typical range where commercial rates average 200% to 300% of Medicare. Since the facility is a Critical Access Hospital owned by the local government, patients should verify their specific plan's allowed amount before scheduling to ensure they are not being billed the full negotiated rate if their deductible has not yet been met. Always request an itemized bill before paying to identify any errors or unbundled codes, as over 80% of hospital bills