Ultrasound, leg veins (duplex)
Facility: Fredonia Regional Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $640
- Cash Discount Price: $712
- vs. Medicare Baseline: 2.63x 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 263% of the Medicare baseline (a markup of 163%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $352 - $481 | 144% |
| UnitedHealthcare | $363 - $710 | 149% |
| Veterans Programs - All Plans | $363 | 149% |
| Aetna | $363 - $640 | 149% |
| Reserve National-All Plans | $640 | 263% |
| Meritain-All Plans | $640 | 263% |
| Cigna | $640 | 263% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Fredonia Regional Hospital in Kansas, the cash price is $712.00, which matches the facility's median negotiated rate of $640.00. This service is significantly more expensive than the Medicare benchmark of $243.77, reflecting a markup of 2.6 times the federal baseline. While commercial payers like Blue Cross Blue Shield and UnitedHealthcare negotiate rates ranging from $352 to $710, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates can vary widely by carrier and may not represent the lowest possible cost.
Patients should proactively ask the hospital about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. These discounts bypass the administrative costs associated with insurance claims processing and provide immediate liquidity to the facility. Additionally, under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, so you should not feel pressured to pay surprise charges immediately. To ensure accuracy, request a detailed itemized bill that lists every CPT code and service rendered, as summary bills often obscure errors or unbundled charges that could be disputed.