CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Lancaster General Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $988
  • Cash Discount Price: $1,294
  • vs. Medicare Baseline: 4.05x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Lancaster General Hospital is $988. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,294. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.05x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$1,294

Average discount available for prompt cash payment at this facility.

Insurance Median
$988

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: $1,294 (531%)
Insurance Median: $988 (405%)
Cash: $1,294 (531% of Medicare)
Ins. Median: $988 (405% 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 405% of the Medicare baseline (a markup of 305%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $91 - $473 37%
UnitedHealthcare $126 - $1,296 52%
Gateway $134 55%
Tricare $218 89%
Hospice And Community Care $221 - $290 91%
Highmark $240 - $1,525 98%
Albright Life $242 99%
Coatesville Va $242 99%
Hospice Generic $242 99%
Lebanon Veterans Hospital $242 99%
Medicare (plans) $242 - $268 99%
Aetna $245 - $1,032 101%
Blue Cross Blue Shield $246 - $1,296 101%
Amerihealth Caritas $247 101%
Upmc For You $249 102%
Cigna $250 - $1,151 103%
Health Partners Mcr Advantage $250 103%
Devoted Health $255 105%
Pa Health And Wellness Mcr $255 105%
Old Order Group $314 - $488 129%
Lg Coresource/Lg Eliance $331 - $435 136%
Elap Employees $344 141%
Lancashire Hall $349 - $1,525 143%
Nursing Home Op Services $349 - $458 143%
Affilia Home Health $465 - $1,525 191%
Oscar Health Plan $473 194%
Masonic Homes $488 - $1,525 200%
Claim Watcher Plus $727 298%
Eliance Health Solutions $744 - $976 305%
Highmark Commercial Preferred $777 - $1,525 319%
Claim Watcher $800 328%
Elap Other Groups $882 362%
Ehp $953 - $1,250 391%
Upmc Commercial $953 - $1,296 391%
Devon $988 - $1,296 405%
Geisinger Commercial $988 - $1,296 405%
Intergroup Services $988 - $1,296 405%
Preferred Healthcare $988 - $1,296 405%
Medi-Share Christian Care $1,104 - $1,449 453%
Commercial Generic $1,162 - $1,525 477%
Highmark Commercial Non-Preferred $1,162 - $1,537 477%
Magellan $1,162 - $1,525 477%
United Behavioral Health $1,162 - $1,525 477%
Value Options $1,162 - $1,525 477%
Workers Compensation $1,162 - $1,525 477%
Gift Of Life Donor Program $13,500 5538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals