Ultrasound, leg veins (duplex)
Facility: Children'S Mercy South
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $158
- Cash Discount Price: $830
- vs. Medicare Baseline: 0.65x 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 |
|---|---|---|
| Wppa Providrs Care | $39 - $2,184 | 16% |
| UnitedHealthcare | $40 - $2,258 | 16% |
| Healthlink | $42 - $2,957 | 17% |
| Healthy Blue | $42 - $608 | 17% |
| Medicaid / KanCare | $43 - $93 | 18% |
| Health Midwest Comprehensive Care | $45 - $2,187 | 18% |
| American Healthcare Alliance | $46 - $2,856 | 19% |
| Quiktrip | $49 - $2,187 | 20% |
| Blue Cross Blue Shield | $51 - $2,486 | 21% |
| Medica | $57 - $1,959 | 23% |
| Aetna | $62 - $2,285 | 25% |
| Multiplan | $62 - $2,554 | 25% |
| Wellfit/Centrus | $62 - $2,184 | 25% |
| Centivo | $64 - $2,184 | 26% |
| Humana | $64 - $2,234 | 26% |
| Nebraska Furniture Mart | $65 - $2,184 | 27% |
| Orscheln | $65 - $2,184 | 27% |
| Mercy Health | $72 - $2,520 | 30% |
| Coxhealth Network | $73 - $2,486 | 30% |
| Cigna | $75 - $2,335 | 31% |
| Coventry Health Care Of Kansas | $79 - $2,486 | 32% |
| National Preferred Provider Network | $86 - $3,024 | 35% |
| Home State Health | $180 - $535 | 74% |
Consumer Guidance & Cost Commentary
For the ultrasound of leg veins (duplex) at Children's Mercy South in Overland Park, KS, the facility's cash price of $830 is significantly lower than the gross chargemaster rate of $1,729. While insurance negotiated rates vary widely among the 23 participating payers—ranging from a low of $39 with Wppa Providers Care to a high of $3,024 with National Preferred Provider Network—the cash price often represents the most transparent baseline for patients. Because commercial insurance rates are frequently inflated by administrative costs and contract markups, paying cash upfront can sometimes result in substantial savings compared to what an insurer might allow, particularly for those with high-deductible plans. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final amount owed.
When comparing pricing to federal benchmarks, the facility's Medicare rate of $243.77 serves as a critical reference point, showing that the cash price is more than three times the Medicare amount. This disparity highlights how commercial rates often exceed the "true cost" of care established by federal standards, which typically range between 120% and 150% of Medicare for fair pricing. If a patient receives an itemized bill from an out-of-network provider at this facility, they may be subject to balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act protects against such unexpected bills for emergency and non-emergency services at in-network facilities. To ensure accuracy, patients should request a detailed, line-by-line itemized audit of their statement to identify any