Ultrasound, leg veins (duplex)
Facility: Smith County Memorial Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $694
- Cash Discount Price: $738
- vs. Medicare Baseline: 2.85x 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 285% of the Medicare baseline (a markup of 185%). 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 | $476 | 195% |
| Medicaid / KanCare | $517 - $738 | 212% |
| Multiplan-All Plans | $664 | 272% |
| Wppa-All Plans | $694 | 285% |
| UnitedHealthcare | $701 | 288% |
| Midlands Choice-All Plans | $701 | 288% |
| Health Partners Of Ks Ppo-All Plans | $701 | 288% |
Consumer Guidance & Cost Commentary
For this ultrasound of leg veins (duplex) at Smith County Memorial Hospital in Smith Center, KS, the cash price is $738, which matches the facility's median negotiated rate. While the hospital is a Critical Access Hospital owned by the local government, the data indicates that commercial insurance plans often pay significantly more than the cash price due to administrative overhead and contract structures. For instance, Medicaid/KanCare plans have a high-end negotiated rate of $738, while other payers like Blue Cross Blue Shield and Multiplan-All Plans have fixed negotiated rates of $476 and $664, respectively. Patients with high-deductible plans or those who have already met their out-of-pocket maximum may find paying the cash price of $738 directly to the hospital more cost-effective than relying on insurance, which could result in higher allowed amounts or balance billing if the service is out-of-network.
To ensure you receive the most accurate pricing, it is essential to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid in full upfront, bypassing the costly claims processing cycle. While the Medicare benchmark for this service is $243.77, commercial rates are often higher due to the inclusion of practice expenses and malpractice insurance; however, comparing your specific plan's allowed amount to the cash price can reveal significant savings. Always verify your deductible status and ensure you are not signing away rights to