Ultrasound, leg veins (duplex)
Facility: Phillips County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $605
- Cash Discount Price: $568
- vs. Medicare Baseline: 2.48x 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 248% of the Medicare baseline (a markup of 148%). 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 | $481 - $541 | 197% |
| UnitedHealthcare | $534 - $668 | 219% |
| Medicaid / KanCare | $668 | 274% |
| Health Partners-All Plans | $668 | 274% |
Consumer Guidance & Cost Commentary
For this ultrasound of the leg veins at Phillips County Hospital in Phillipsburg, KS, the facility's negotiated rates range from $481 to $668 depending on your specific insurance plan, with the highest negotiated amount matching the gross charge of $668. While the facility is a Critical Access Hospital owned by the local government, the cash price of $568 is notably lower than the median negotiated rate of $605. If you have a high-deductible plan or have not yet met your deductible, paying the cash price upfront could save you money compared to your insurance's negotiated rate, which often includes administrative overhead that inflates the baseline cost.
To understand the true value of this service, it is helpful to compare the facility's pricing against the Medicare benchmark, which serves as the objective baseline for healthcare costs. The Medicare amount for this procedure is $243.77, meaning the facility's cash price of $568 represents a significant markup over the federal government's calculated cost. Additionally, the median negotiated rate of $605 is higher than the cash price, illustrating that commercial insurance contracts often result in higher out-of-pocket costs for patients who have not met their deductible. Before scheduling, we recommend requesting a prompt-pay discount for self-pay patients, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass the costly insurance billing cycle.