CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Penn Presbyterian Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,167
  • Cash Discount Price: $2,343
  • vs. Medicare Baseline: 4.79x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Penn Presbyterian Medical Center is $1,167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,343. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.79x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$2,343

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,167

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: $2,343 (961%)
Insurance Median: $1,167 (479%)
Cash: $2,343 (961% of Medicare)
Ins. Median: $1,167 (479% 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 479% of the Medicare baseline (a markup of 379%). 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.

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
Health Partners $91 - $2,740 37%
Medicaid / KanCare $114 - $2,740 47%
Keystone Mercy Health Plan $146 - $2,740 60%
Pa Medical Assistance $147 60%
Upmc $194 - $2,740 80%
UnitedHealthcare $225 - $2,740 92%
Blue Cross Blue Shield $250 - $2,740 103%
Medicare (plans) $250 - $255 103%
Philadelphia Va Medical Center $250 103%
Tricare $251 103%
Ibc $255 105%
Cigna $257 - $1,009 105%
Geisinger Health Plan $257 - $791 105%
Humana $257 - $2,192 105%
Pa Health And Wellness $262 - $412 107%
Penn Life (Living Independently For Elders) $262 107%
Aetna $265 - $2,740 109%
Clover Health Plan $270 111%
Keystone First $277 114%
Us Family Health Plan $288 118%
Gateway Health Plan $309 127%
Horizon Nj Health $329 - $482 135%
Elap $354 145%
Claims Watcher $399 - $449 164%
Oscar Health Plan $424 174%
Pgm - Regie De L'Assurance Maladie Quebec $447 - $630 183%
Centivo $449 184%
Elap Services $464 190%
Preferred Health Care Eliance $486 - $685 199%
Highmark $525 215%
Ibc Commercial Hpn $630 258%
Keystone Hmo Proactive $646 265%
Penn Global Medicine $661 271%
Pgm - Kuwait Defense $681 - $1,233 279%
Devon $739 - $1,233 303%
Qualcare $739 - $1,041 303%
Coventry $778 - $1,397 319%
Pgm - Chop $778 - $1,096 319%
Wissahickon Hospice $778 - $1,096 319%
Healthamerica/Coventry $875 - $1,343 359%
Olympus $922 - $1,299 378%
First Health Global $972 - $1,370 399%
Urn-Cancer Resource Services $972 - $1,370 399%
Health Net $1,167 - $1,644 479%
Pgm - Royal Embassy Of Saudi Arabia $1,167 - $1,644 479%
Pgm - Embassy Of Qatar $1,264 - $1,781 519%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $1,264 - $1,781 519%
Pgm - Embassy Of The United Emirates/Ipc $1,362 - $1,918 559%
Devon Health Services Inc $1,556 - $2,192 638%
Health America/Ccn $1,556 - $2,192 638%
Intergroup $1,556 - $2,192 638%
Pgm - Kuwait Health Division $1,556 - $2,192 638%
Pgm - Kuwait Oil $1,556 - $2,192 638%
Preferred Care $1,556 - $2,192 638%
Commercial Other $1,945 - $2,740 798%
International Pfs $1,945 - $2,740 798%
Magellan $1,945 - $2,740 798%
Quest Behavioral Health $1,945 - $2,740 798%
United Behavioral Health $1,945 - $2,740 798%
Workers Compensation $1,945 - $2,740 798%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals