CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: UPMC Bedford Memorial

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $481
Cash Discount Price: $467
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at UPMC Bedford Memorial is $481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $467. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.97x the Medicare baseline. Located in 10455 Lincoln Highway, Everett, PA.

Cash / Self-Pay

$467

Average discount available for prompt cash payment at this facility.

Insurance Median

$481

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: $467 (192%)

Insurance Median: $481 (197%)

Cash: $467 (192% of Medicare)

Ins. Median: $481 (197% 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	$83 - $521	34%
UnitedHealthcare	$154 - $521	63%
Upmc Health Plan	$161 - $581	66%
Geisinger	$204	84%
Highmark Wholecare (Prev Gateway)	$218 - $249	89%
Health Partners Plans (Jefferson Health Plan)	$221	91%
Amerihealth Caritas	$229 - $249	94%
Blue Cross Blue Shield	$230 - $540	94%
Cigna	$249 - $521	102%
Pa Health & Wellness	$249 - $250	102%
Upmc Work Partners	$416	171%
Intergroup	$506 - $700	208%
Coventry/First Health	$545	224%
Preferred Healthcare System	$622	255%
Health Coalition Partners	$700	287%
Humana	$700	287%
Private Health Care Systems	$700	287%
Selectcare	$700	287%

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 $467.
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 Bedford Memorial 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.