Ultrasound, leg veins (duplex)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $496
- Cash Discount Price: $894
- vs. Medicare Baseline: 2.03x 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 203% of the Medicare baseline (a markup of 103%). 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 |
|---|---|---|
| Aetna | $411 - $715 | 169% |
| Blue Cross Blue Shield | $481 | 197% |
| UnitedHealthcare | $512 | 210% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Community Memorial Healthcare, Inc. in Marysville, KS, the cash price is $894.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average, as indicated by a 2.0x multiplier compared to Medicare's benchmark rate of $243.77. While commercial insurance plans like Aetna, Blue Cross Blue Shield, and UnitedHealthcare negotiate rates ranging from $411 to $512, these amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurer's negotiated payment could result in a higher out-of-pocket cost than paying the full cash price upfront.
To minimize potential balance billing or unexpected charges, patients should verify their insurance status and explicitly request a "self-pay" or "prompt-pay" discount before scheduling the procedure. Although the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients should still avoid signing consent waivers that might waive these protections for emergency or mandatory ancillary services. If a summary bill is received, it is critical to demand a full itemized CPT-coded statement to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.