CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: UPMC Altoona

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $479
Cash Discount Price: $1,053
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at UPMC Altoona is $479. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,053. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.96x the Medicare baseline. Located in 620 Howard Avenue, Altoona, PA.

Cash / Self-Pay

$1,053

Average discount available for prompt cash payment at this facility.

Insurance Median

$479

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: $1,053 (432%)

Insurance Median: $479 (196%)

Cash: $1,053 (432% of Medicare)

Ins. Median: $479 (196% 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
Aetna	$114 - $930	47%
UnitedHealthcare	$120 - $900	49%
Upmc Health Plan	$126 - $522	52%
Blue Cross Blue Shield	$158	65%
Geisinger	$159 - $965	65%
Highmark Wholecare (Prev Gateway)	$169 - $878	69%
Health Partners Plans (Jefferson Health Plan)	$172	71%
Amerihealth Caritas	$178	73%
Pa Health & Wellness	$195	80%
Upmc Work Partners	$306	126%
Cigna	$878	360%
Preferred Healthcare System	$878	360%
Private Health Care Systems	$1,404	576%

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 $1,053.
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 UPMC Altoona 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.