CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Clarion Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $269
  • Cash Discount Price: $478
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Clarion Hospital is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $478. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.10x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$478

Average discount available for prompt cash payment at this facility.

Insurance Median
$269

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: $478 (196%)
Insurance Median: $269 (110%)
Cash: $478 (196% of Medicare)
Ins. Median: $269 (110% 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.

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
Upmc $86 - $585 35%
Medicaid / KanCare $147 60%
Amerihealth $161 - $233 66%
Jefferson Health Plan $161 66%
Geisinger $176 - $244 72%
Highmark $183 - $398 75%
Highmark - Ind.& Managed Care $183 - $522 75%
Martin'S Point - Usfhp $188 - $410 77%
Gateway $199 - $433 82%
Devoted Health Plan $215 - $468 88%
Highmark Community Blue $232 95%
Cigna $233 - $585 96%
Medicare (plans) $233 96%
Tricare $233 96%
UnitedHealthcare $233 96%
Aetna $240 - $1,041 98%
The Health Plan $246 - $546 101%
Pa Health & Wellness $249 102%
American Health Plan $256 105%
Peak Health $376 - $819 154%
Devon $403 - $878 165%
Workers Comp $433 178%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals