CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Schuylkill Medical Center - South Jackson Street

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $242
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Schuylkill Medical Center - South Jackson Street is $242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.99x the Medicare baseline. Located in 420 South Jackson Street, Pottsville, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$242

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%)

Insurance Median: $242 (99%)

Ins. Median: $242 (99% 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
Blue Cross Blue Shield	$105 - $239	43%
Geisinger	$107 - $581	44%
Highmark Blue Shield	$107 - $755	44%
Amerihealth	$108 - $246	44%
Cigna	$108 - $246	44%
UnitedHealthcare	$109 - $248	45%
Aetna	$110 - $1,324	45%
Jefferson Health Partners	$110 - $478	45%
Devoted Health	$111 - $253	46%
Humana	$111 - $253	46%
Upmc	$111 - $1,163	46%
Gateway	$112 - $255	46%
Emblem	$113 - $1,065	46%
Amerihealth Caritas	$115 - $169	47%
Pa Health & Wellness (Allwell)	$116 - $263	48%
Highmark Wholecare/Gateway	$127 - $186	52%
Pa Health & Wellness	$135 - $198	55%
Ambetter / Centene	$319 - $724	131%
Valley Preferred	$612 - $1,392	251%

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 $X.
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 Schuylkill Medical Center - South Jackson Street 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.