CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Pottstown Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,233
Cash Discount Price: $685
vs. Medicare Baseline: 5.06x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Pottstown Hospital is $1,233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $685. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.06x the Medicare baseline. Located in 1600 East High Street, Pottstown, PA.

Cash / Self-Pay

$685

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,233

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: $685 (281%)

Insurance Median: $1,233 (506%)

Cash: $685 (281% of Medicare)

Ins. Median: $1,233 (506% 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 506% of the Medicare baseline (a markup of 406%). 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
Geisinger	$137 - $1,233	56%
Health Partners	$143	59%
PA Health and Wellness	$143	59%
Gateway	$160	66%
UPMC	$160 - $2,056	66%
Aetna	$194 - $539	80%
Keystone First	$980	402%
Blue Cross Blue Shield	$1,740 - $2,181	714%
First Health	$2,467	1012%
Devon	$2,686	1102%

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 $685.
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 Pottstown Hospital 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.