CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Penn State Health St. Joseph

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $277
Cash Discount Price: $409
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Penn State Health St. Joseph is $277. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $409. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.14x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$409

Average discount available for prompt cash payment at this facility.

Insurance Median

$277

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: $409 (168%)

Insurance Median: $277 (114%)

Cash: $409 (168% of Medicare)

Ins. Median: $277 (114% 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
[Amerihealth Caritas]	$206 - $243	85%
[Highmark Wholecare]	$206 - $243	85%
[Geisinger]	$218 - $1,133	89%
[Health Partners Plans]	$226 - $248	93%
[Pa Health & Wellness]	$227 - $250	93%
[Highmark]	$240 - $1,319	98%
UnitedHealthcare	$243 - $1,064	100%
[Cbc]	$243 - $830	100%
[Ibc]	$243 - $781	100%
Aetna	$245 - $802	101%
Humana	$245	101%
[Healthspring]	$245	101%
[Upmc]	$248 - $1,161	102%
[Point Comfort Underwriters]	$303	124%
Cigna	$741	304%
[Highmark Choice Blue]	$1,055	433%
[Highmark Aca]	$1,108	455%
[Preferred Healthcare Systems]	$1,178	483%
[First Health]	$1,257	516%
[Multiplan]	$1,257	516%

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 $409.
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 Penn State Health St. Joseph 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.