Ultrasound, leg veins (duplex)
Facility: Susan B Allen Memorial Hospital
Billing Code: 93970 (CPT)
- CPT Billing Code: 93970
- Insurance Median: $554
- Cash Discount Price: $659
- vs. Medicare Baseline: 2.27x 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 227% of the Medicare baseline (a markup of 127%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 144% |
| Providrs Care | $757 | 311% |
Consumer Guidance & Cost Commentary
For the CPT code 93970 (Ultrasound, leg veins), Susan B Allen Memorial Hospital in El Dorado, KS, lists a cash median price of $659.00, which is significantly lower than the facility's gross charge of $1,014.00. While the hospital offers negotiated rates of $554.00 to UnitedHealthcare and $757.00 to Providrs Care, these insurance amounts exceed the cash price, meaning patients with high-deductible plans or those without coverage may save money by paying the cash rate directly. It is important to verify your specific plan's allowed amount before scheduling, as in-network contracts can sometimes result in higher out-of-pocket costs than self-pay options.
The facility's pricing is evaluated against a Medicare benchmark of $243.77, showing a markup ratio of 2.3 times the Medicare rate. This comparison highlights that commercial negotiated rates often include administrative overhead and contract dynamics that push prices well above the federal baseline. To ensure you are receiving the most accurate billing information, always request a full itemized bill rather than accepting a summary invoice, which can obscure individual charges. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total amount owed if you settle the account in full within a short timeframe.