CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Luke's Hospital - Upper Bucks Campus

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $511
  • Cash Discount Price: $5,986
  • vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Luke's Hospital - Upper Bucks Campus is $511. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,986. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.10x the Medicare baseline. Located in 3000 St. Luke's Drive, Quakertown, PA.
Cash / Self-Pay
$5,986

Average discount available for prompt cash payment at this facility.

Insurance Median
$511

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: $5,986 (2456%)
Insurance Median: $511 (210%)
Cash: $5,986 (2456% of Medicare)
Ins. Median: $511 (210% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 210% of the Medicare baseline (a markup of 110%). 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.

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
Keystone First $147 60%
Geisinger $173 - $1,870 71%
Amerihealth Caritas $176 72%
Highmark Wholecare $176 72%
Upmc Health Plan $176 - $1,823 72%
Jefferson Health Plan $211 87%
Blue Cross Blue Shield $247 - $5,508 101%
Highmark $247 - $855 101%
Aetna $252 - $2,321 103%
Humana $257 105%
UnitedHealthcare $267 - $1,922 110%
Oscar $1,726 708%
Cigna $1,820 747%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 St. Luke's Drive, Quakertown, PA 18951
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals