Ultrasound, leg veins (duplex)
Facility: Sheridan County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $662
- Cash Discount Price: $920
- 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 |
|---|---|---|
| Celtic Insurance | $533 - $580 | 219% |
| Blue Cross Blue Shield | $662 | 272% |
| UnitedHealthcare | $837 - $910 | 343% |
Consumer Guidance & Cost Commentary
For the CPT code 93970, representing an ultrasound of leg veins, Sheridan County Hospital in Hoxie, KS, lists a cash price of $920.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average for this service, as indicated by a 2.7x multiplier relative to Medicare's benchmark rate of $243.77. While commercial payers like Celtic Insurance and UnitedHealthcare have negotiated rates ranging from $533 to $910, these figures often exceed the cash price for patients with high-deductible plans. In such cases, paying the full cash price of $920.00 upfront can sometimes result in lower out-of-pocket costs compared to the insurance negotiated rates, provided the patient's deductible has not yet been met.
Patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these programs can reduce the final bill by 20% to 50% when paid in full within 30 days. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected ancillary charges or summary bills may still occur. To avoid overpayment, consumers should request a detailed, itemized CPT-coded bill rather than accepting a summary invoice, and they should dispute any charges for services not rendered or unbundled components. Always confirm your specific plan's deductible status and network tiering with the hospital prior to receiving care to ensure you are aware of all potential costs.