CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $449
Cash Discount Price: $669
vs. Medicare Baseline: 1.84x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Independence Health System Butler Memorial Hospita is $449. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $669. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.84x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

$669

Average discount available for prompt cash payment at this facility.

Insurance Median

$449

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: $669 (274%)

Insurance Median: $449 (184%)

Cash: $669 (274% of Medicare)

Ins. Median: $449 (184% 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
Upmc	$86 - $1,228	35%
Amerihealth	$126 - $244	52%
Highmark	$139 - $491	57%
Highmark - Ind.& Managed Care	$139 - $545	57%
Highmark Aca - Direct Blue	$139 - $307	57%
Highmark Community Blue	$139 - $481	57%
Medicaid / KanCare	$147	60%
UnitedHealthcare	$147 - $596	60%
Geisinger	$160 - $1,170	66%
Jefferson Health Plan	$161	66%
Gateway	$166 - $1,228	68%
Aetna	$169 - $936	69%
Ellwood Group	$223 - $503	91%
Life Butler County	$233	96%
Martin'S Point - Usfhp	$233 - $410	96%
Medicare (plans)	$233	96%
Peak Health	$233 - $819	96%
Provider Partners	$233	96%
Tricare	$233	96%
Workers Comp	$239	98%
Humana	$242	99%
Devoted Health Plan	$246 - $468	101%
The Health Plan	$246 - $546	101%
Pa Health & Wellness	$249	102%
American Health Plan	$256	105%
Pnoa	$256 - $936	105%
Ccbh - Behavioral Health	$353 - $585	145%
Cigna	$371 - $585	152%
Private Healthcare Systems	$519 - $994	213%
Devon	$556 - $878	228%
Intergroup	$594 - $936	244%
Multiplan	$668 - $1,053	274%

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 $669.
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 Independence Health System Butler Memorial Hospita 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.