Ultrasound, leg veins (duplex)
Facility: William Newton Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $337
- Cash Discount Price: $918
- vs. Medicare Baseline: 1.38x 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 |
|---|---|---|
| Triwest- All Plans | $314 - $326 | 129% |
| Ambetter / Centene | $324 - $935 | 133% |
| UnitedHealthcare | $324 - $842 | 133% |
| Blue Cross Blue Shield | $324 - $457 | 133% |
| Providrs Care Nexus | $551 - $572 | 226% |
| Providrs Care - All Other Plans | $630 - $654 | 258% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at William Newton Hospital in Winfield, KS, the cash price is $918.00, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by a ratio of 1.4 times the Medicare benchmark of $243.77. While commercial payers like Triwest and Ambetter have negotiated rates ranging from $314 to $935, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket or utilizing prompt-pay discounts. It is important to note that while the facility is in-network for many plans, the negotiated rates do not always represent the lowest possible cost, and patients should verify their specific deductible status before scheduling to avoid unexpected out-of-pocket expenses.
The facility, a Critical Access Hospital owned by the local government, has a facility rating of 4. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services are out-of-network. To ensure accuracy, consumers should request a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Additionally, asking for a "waiver of insurance submission" at registration can prevent automatic claims that void potential cash discounts, allowing patients to negotiate directly for prompt-pay reductions that typically range from 20% to 50% of the total bill.