CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Reading Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $44
Cash Discount Price: $937
vs. Medicare Baseline: 0.18x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Reading Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $937. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.18x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.

Cash / Self-Pay

$937

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $937 (384%)

Insurance Median: $44 (18%)

Cash: $937 (384% of Medicare)

Ins. Median: $44 (18% 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
Humana	$26 - $32	11%
UnitedHealthcare	$30 - $2,088	12%
Amerihealth Caritas	$31 - $146	13%
Blue Cross Blue Shield	$31 - $1,485	13%
Highmark	$31 - $39	13%
Upmc	$31 - $1,392	13%
Aetna	$32 - $1,856	13%
Devoted Health	$32	13%
Geisinger	$32 - $2,551	13%
Health America	$32	13%
Gateway	$33 - $146	14%
Health Partners	$33 - $146	14%
Pa Health & Wellness	$33 - $143	14%
Lehigh Valley Health Network	$44 - $1,160	18%
Cigna	$92 - $1,475	38%
Keystone First	$137	56%
Wernersville State Hospital	$148	61%
First Health	$564 - $1,815	231%
Pma	$1,031	423%
Berkshire	$1,934	793%
Blue Ridge	$2,449	1005%

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 $937.
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 Reading 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.