CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Clay County Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $66
  • Cash Discount Price: $608
  • vs. Medicare Baseline: 0.27x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Clay County Medical Center is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $608. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.27x the Medicare baseline. Located in 617 Liberty, Clay Center, KS.
Cash / Self-Pay
$608

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $608 (249%)
Insurance Median: $66 (27%)
Cash: $608 (249% of Medicare)
Ins. Median: $66 (27% 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
Multiplan- All Plans $32 - $1,088 13%
UnitedHealthcare $41 - $1,088 17%
Wppa/Providrs Care- All Plans $65 - $1,065 27%
Aetna $65 - $1,065 27%
Health Partners - All Plans $66 - $1,088 27%

Consumer Guidance & Cost Commentary

For the CPT code 93970, representing an ultrasound of leg veins, Clay County Medical Center in Clay Center, KS, lists a cash median price of $608.00. This cash rate is significantly higher than the state average for this procedure, which is $248.00. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that commercial insurance negotiated rates can sometimes exceed the cash price. For instance, the median negotiated rate across payers is $66.00, yet individual plan maximums range from $65 to $1,088. If you have a high-deductible plan, paying the cash price of $608.00 upfront might be more cost-effective than your insurance paying a negotiated rate that exceeds this amount, provided you have not yet met your deductible.

To ensure you are receiving the most accurate pricing, it is crucial to request an itemized billing audit before finalizing payment. Hospitals often issue summary bills that obscure individual charges, but an itemized statement reveals the exact CPT codes and unit costs, helping to identify errors, unbundled services, or charges for items not rendered. Additionally, you should inquire about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims. Always verify your specific plan's allowed amount and deductible status before scheduling, as assuming that being in-network guarantees the lowest price can lead to unexpected costs if your plan's negotiated rate is higher than the cash option.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 617 Liberty, Clay Center, KS 67432
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals