CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: UPMC Passavant

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $536
Cash Discount Price: $2,092
vs. Medicare Baseline: 2.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at UPMC Passavant is $536. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,092. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.20x the Medicare baseline. Located in 9100 Babcock Boulevard, Pittsburgh, PA.

Cash / Self-Pay

$2,092

Average discount available for prompt cash payment at this facility.

Insurance Median

$536

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: $2,092 (858%)

Insurance Median: $536 (220%)

Cash: $2,092 (858% of Medicare)

Ins. Median: $536 (220% 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 220% of the Medicare baseline (a markup of 120%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$159 - $1,116	65%
Upmc Health Plan	$161 - $695	66%
UnitedHealthcare	$169 - $254	69%
Highmark Wholecare (Prev Gateway)	$218 - $249	89%
Amerihealth Caritas	$229 - $249	94%
Health Plan Of Upper Ohio Valley	$230 - $1,611	94%
Aetna	$242 - $254	99%
Pa Health & Wellness	$249 - $250	102%
Upmc Work Partners	$461	189%
Private Health Care Systems	$536 - $3,243	220%
Cigna	$1,186 - $1,395	487%
Coventry/First Health	$2,441	1001%
Intergroup	$2,894 - $3,138	1187%
Humana	$2,964 - $3,243	1216%
Multiplan	$2,964 - $3,243	1216%

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 $2,092.
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 Passavant 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.