CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Lincoln County Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $481
  • Cash Discount Price: $651
  • vs. Medicare Baseline: 1.97x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Lincoln County Hospital is $481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $651. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.97x the Medicare baseline. Located in 624 N Second, Lincoln, KS.
Cash / Self-Pay
$651

Average discount available for prompt cash payment at this facility.

Insurance Median
$481

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $651 (267%)
Insurance Median: $481 (197%)
Cash: $651 (267% of Medicare)
Ins. Median: $481 (197% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

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 $481 197%

Consumer Guidance & Cost Commentary

For this ultrasound of leg veins (duplex) at Lincoln County Hospital in Lincoln, KS, the facility's negotiated rate with Blue Cross Blue Shield is $481, which matches the lowest and highest reported rates for this service in the area. This negotiated amount is significantly higher than the cash median of $651, meaning patients paying out-of-pocket directly may find the cash price more favorable if their insurance deductible has not yet been met. It is important to note that while commercial negotiated rates often include administrative overhead and claims processing costs, the cash price here is actually lower than the insurer's allowed amount, suggesting that paying upfront could result in immediate savings for those without active coverage or high-deductible plans.

The facility's pricing also compares favorably against federal benchmarks, with the Medicare amount of $243.77 serving as a baseline for the true cost of care. While the gross charge listed is $724, the actual payment expected by the insurer is $481, indicating a substantial markup on the federal rate. Patients should be aware that hospitals like this Critical Access Hospital often offer prompt-pay discounts for self-pay patients who settle their bills in full within 30 days, which can further reduce the final cost. To ensure you receive the best possible rate, it is recommended to explicitly request a self-pay classification and ask about any prompt-pay discounts before scheduling your appointment, rather than waiting until after the service is rendered.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 624 N Second, Lincoln, KS 67455
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals