CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: The Children's Mercy Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $158
Cash Discount Price: $830
vs. Medicare Baseline: 0.65x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at The Children's Mercy Hospital is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $830. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.65x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$830

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $830 (340%)

Insurance Median: $158 (65%)

Cash: $830 (340% of Medicare)

Ins. Median: $158 (65% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $830.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93970.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93970.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.