CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Saint Vincent Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $191
Cash Discount Price: $1,190
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Saint Vincent Hospital is $191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,190. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.78x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.

Cash / Self-Pay

$1,190

Average discount available for prompt cash payment at this facility.

Insurance Median

$191

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: $1,190 (488%)

Insurance Median: $191 (78%)

Cash: $1,190 (488% of Medicare)

Ins. Median: $191 (78% 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
Univera	$27 - $218	11%
Amerihealth	$34 - $276	14%
Highmark	$38 - $384	16%
Pennsylvania Health And Wellness	$43 - $220	18%
Geisinger	$47 - $235	19%
UnitedHealthcare	$47 - $7,103	19%
Cigna	$52 - $613	21%
Aetna	$126 - $535	52%
University Of Pittsburgh Medical Center	$131 - $323	54%
Highmark Wholecare	$158 - $279	65%
Jefferson Health Plans	$175 - $224	72%
American Health Plans	$263	108%
Life Pittsburgh	$263	108%
Martin'S Point	$263 - $451	108%
Medicare (plans)	$271	111%
Blue Cross Blue Shield	$276 - $414	113%
Humana	$279	114%
Molina	$287	118%
Medical Mutual	$561	230%

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 $1,190.
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 Saint Vincent 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.