Ultrasound, leg veins (duplex)
Facility: Cloud County Health Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $727
- Cash Discount Price: $536
- vs. Medicare Baseline: 2.98x 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 298% of the Medicare baseline (a markup of 198%). 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 |
|---|---|---|
| Mpi-All Plans | $43 - $1,524 | 18% |
| Pponext-All Plans | $118 - $1,524 | 48% |
| Aetna | $689 - $1,492 | 283% |
| Health Partners - All Plans | $727 - $1,524 | 298% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure of leg veins (duplex) at Cloud County Health Center in Concordia, KS, the facility's cash median price is $536.00, which is lower than the state average of $727.00. While the facility's negotiated rates with major payers like Aetna and Health Partners range from $689 to $1,524, patients with high-deductible plans may find paying the cash price directly more cost-effective, as the cash rate is significantly below the insurance negotiated amounts. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
It is important to note that the facility's cash price of $536.00 is also lower than the Medicare benchmark amount of $243.77 when adjusted for the specific code context, though the primary comparison here is against the commercial negotiated rates which average higher due to administrative overhead. Patients should avoid accepting summary bills and instead demand a full itemized statement to ensure no unbundled codes or services not rendered are included in the final charge. If a patient receives a balance bill from an out-of-network provider, they may be entitled to protections under the No Surprises Act, but for this in-network service, the most effective strategy is to verify the cash price and secure a prompt-pay discount prior to receiving care.