Ultrasound, leg veins (duplex)
Facility: Memorial Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $727
- Cash Discount Price: $765
- vs. Medicare Baseline: 2.98x 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 298% of the Medicare baseline (a markup of 198%). 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 |
|---|---|---|
| Tricare | $30 - $802 | 12% |
| Ambetter / Centene | $33 - $882 | 14% |
| Humana | $383 - $802 | 157% |
| Medicare (plans) | $386 - $810 | 158% |
| Blue Cross Blue Shield | $508 | 208% |
| Coventry - All Other Plans | $689 - $1,444 | 283% |
| Preferred Healthcare-All Plans | $727 - $1,524 | 298% |
| Health Partners Of Kansas - All Plans | $727 - $1,524 | 298% |
| Wppa/Providers Care-All Plans | $1,071 - $2,246 | 439% |
Consumer Guidance & Cost Commentary
For CPT code 93970, an ultrasound of the leg veins, Memorial Hospital in Abilene, KS, lists a cash price of $765.00, which matches the median paid amount. This cash rate is significantly higher than the Medicare benchmark of $243.77, reflecting a markup of 300% above the federal baseline. While commercial negotiated rates range from $30 to $2,246 depending on the insurance plan, the cash price remains the lowest fixed amount available for this service. Patients with high-deductible plans may find paying the full cash price upfront more cost-effective than using insurance, as many commercial contracts exceed the cash rate to cover administrative processing fees. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these incentives can further reduce the final bill.
The facility is a Critical Access Hospital owned by a Government Hospital District, and while the facility rating is 2, the pricing data shows a wide variance in commercial payments. For instance, while Tricare and Ambetter/Centene have negotiated rates starting as low as $30, plans like Coventry and Preferred Healthcare can result in payments up to $1,524. Because commercial rates often include administrative overhead and vary by network tier, the cash price of $765.00 serves as a reliable floor for comparison. To ensure you are not overcharged, request a detailed, itemized bill that breaks down every CPT code and charge, as summary bills often obscure unbundled services or items not rendered. Disputing any errors in writing with the billing supervisor is the most effective way