Ultrasound, leg veins (duplex)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $657
- Cash Discount Price: $706
- vs. Medicare Baseline: 2.70x 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 270% of the Medicare baseline (a markup of 170%). 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 |
|---|---|---|
| Humana | $407 | 167% |
| Tricare | $439 | 180% |
| Va Ccn - All Plans | $515 | 211% |
| Medicaid / KanCare | $515 - $830 | 211% |
| UnitedHealthcare | $515 - $830 | 211% |
| Aetna | $515 - $747 | 211% |
| Ambetter / Centene | $566 | 232% |
| Blue Cross Blue Shield | $657 | 270% |
| Health Partners - All Plans | $788 | 323% |
| Healthy Blue Mcaid - All Plans | $830 | 340% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Trego County Lemke Memorial Hospital in Wakeeney, Kansas, the facility's negotiated rates range from $407 to $830, with a median negotiated amount of $657. This median rate is notably higher than the state average of $515, reflecting the typical administrative overhead and contract dynamics where commercial insurance payers cover a significant portion of the cost. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash-pay options may offer a lower out-of-pocket cost; the cash median price is $706, which is higher than the state average but lower than the highest negotiated rates seen for some payers. Because commercial rates often include multi-layered administrative structures that inflate the baseline price by 20% to 40%, patients with high-deductible plans might find that paying the cash price directly is more economical than relying on insurance, provided the insurance allowed amount exceeds the cash rate.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill by 20% to 50% by bypassing costly claims processing and administrative labor. It is crucial to verify the specific allowed amount for your insurance plan rather than assuming that being in-network guarantees the lowest possible price, as different payers have distinct contract ceilings. Additionally, since Medicare serves as the objective baseline for healthcare costs, the facility's Medicare amount of $243.77 provides a clear benchmark; commercial rates often average 200% to 300% of this figure, whereas fair pricing is typically defined