Ultrasound, leg veins (duplex)
Facility: Girard Medical Center
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $356
- Cash Discount Price: $610
- vs. Medicare Baseline: 1.46x 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.
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 |
|---|---|---|
| Medicare (plans) | $356 | 146% |
| UnitedHealthcare | $356 - $966 | 146% |
| Humana | $356 | 146% |
| Aetna | $356 - $1,780 | 146% |
| Blue Cross Blue Shield | $356 - $481 | 146% |
| Ambetter / Centene | $356 | 146% |
| Kansas Superior Select-All Plans | $356 | 146% |
| Multiplan-All Plans | $941 | 386% |
| Uhhis-All Plans | $966 | 396% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Girard Medical Center in Girard, Kansas, the facility's cash median rate is $610.00, while the median negotiated rate for in-network insurance is $356.00. This service is provided by a Critical Access Hospital owned by a Government Hospital District, and the Medicare benchmark for this procedure is $243.77. When comparing commercial rates to the Medicare baseline, the negotiated average of $356.00 represents a 1.5x markup relative to the federal government's fixed reimbursement rate. While commercial contracts often average 200% to 300% of Medicare, fair pricing is typically defined as 120% to 150% of this baseline. For patients with high-deductible plans, paying the cash price of $610.00 upfront might be more cost-effective if their insurance negotiated rate exceeds this amount, though the current data shows the negotiated rate is lower.
Patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary significantly across different carriers. For this procedure, the lowest allowed amount among participating payers is $356.00, with the highest reaching $1,780.00 depending on the insurer. If you are self-pay or have a plan with a high deductible, you should ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within 30 days. Additionally, if you receive an itemized bill, request a full line-by-line statement to identify any