Ultrasound, leg veins (duplex)
Facility: Scott County Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $957
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.93x 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 393% of the Medicare baseline (a markup of 293%). 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 | $79 - $1,010 | 32% |
| Humana | $446 | 183% |
| Blue Cross Blue Shield | $481 | 197% |
| Wppa | $638 - $1,200 | 262% |
| Aetna | $957 | 393% |
Consumer Guidance & Cost Commentary
For the CPT code 93970, representing an ultrasound of leg veins, Scott County Hospital in Scott City, KS, has a gross charge of $1,063.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates for commercial payers range from $79 to $1,200, with a median negotiated amount of $957.00. This median negotiated rate is significantly higher than the Medicare benchmark of $243.77, reflecting the typical administrative overhead and contract dynamics that inflate commercial pricing. Patients should be aware that while in-network insurance contracts provide a ceiling on charges, these rates often exceed what a patient would pay out-of-pocket, particularly if their plan has a high deductible.
To potentially lower costs, patients should verify if the facility offers a "self-pay" or "prompt-pay" discount, which can reduce the bill by 20% to 50% for upfront payment. Since the cash median is not available in the current data, it is unclear if paying directly would be cheaper than the insurance negotiated rate, but asking the billing department before scheduling is essential to avoid automatic claims submission that voids cash discounts. Additionally, because over 80% of hospital bills contain errors, patients should request a full itemized, CPT-coded statement rather than accepting a summary bill, and dispute any discrepancies in writing to ensure they are not being charged for services not rendered or unbundled components.