Ultrasound, leg veins (duplex)
Facility: Osborne County Memorial Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $793
- Cash Discount Price: $745
- vs. Medicare Baseline: 3.25x 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 325% of the Medicare baseline (a markup of 225%). 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 |
|---|---|---|
| UnitedHealthcare | $666 | 273% |
| Health Partners Of Kansas | $753 | 309% |
| Wppa | $832 | 341% |
| Blue Cross Blue Shield | $858 | 352% |
Consumer Guidance & Cost Commentary
For CPT code 93970, representing an ultrasound of leg veins, the gross charge at Osborne County Memorial Hospital is $876.00. This facility, a Critical Access Hospital in Osborne, KS, has a cash median price of $745.00, which is notably lower than the negotiated rates paid by major payers such as UnitedHealthcare ($666), Health Partners Of Kansas ($753), Wppa ($832), and Blue Cross Blue Shield ($858). While the cash price is the lowest figure available, patients with high-deductible plans may find that paying the cash median of $745.00 upfront is more cost-effective than relying on insurance, as the negotiated rates exceed the cash price. It is important to note that while the facility offers a cash median, the specific "self-pay" or "prompt-pay" discounts available to you may vary and should be confirmed directly with the hospital before scheduling.
The Medicare benchmark for this service is $243.77, which serves as a critical baseline for evaluating the facility's pricing markup. The gross charge of $876.00 represents a significant increase over the Medicare amount, a common practice where commercial rates are marked up to cover administrative costs and profit margins. If you receive a bill from this facility, you should request an itemized billing audit to ensure no errors, such as unbundled codes or services not rendered, have inflated your total, as over 80% of hospital bills contain errors. Additionally, be aware of federal protections under the No Surprises Act, which generally prevents balance billing for out-of-network providers at in-network facilities,