Ultrasound, leg veins (duplex)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $554
- Cash Discount Price: $492
- vs. Medicare Baseline: 2.27x 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 227% of the Medicare baseline (a markup of 127%). 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 | $452 - $476 | 185% |
| UnitedHealthcare | $554 - $615 | 227% |
| Providers Care (Wppa)-All Plans | $1,076 | 441% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure for leg veins at the Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash price of $492.00 is lower than the median negotiated rate of $554.00 paid by UnitedHealthcare and the median allowed amount of $554.00. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans might find paying the cash price directly more beneficial if their insurance negotiated rate exceeds this amount. It is important to note that commercial rates often include administrative overhead and contract dynamics that can inflate the baseline price, so comparing the cash rate to the Medicare benchmark of $243.77 reveals a significant markup. Patients should always verify their specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in unexpected out-of-pocket costs.
To avoid potential balance billing or errors, consumers should request a full itemized bill before finalizing payment, as summary bills often obscure individual charges. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to ensure no ancillary services were billed separately. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid upfront, bypassing the costly claims processing cycle. Given that over 80% of hospital bills contain errors, disputing any discrepancies in writing with a certified letter to the billing supervisor is the most effective way to reduce medical debt and ensure the final invoice accurately reflects the services rendered.