CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Wellspan Ephrata Community Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $798
  • Cash Discount Price: $994
  • vs. Medicare Baseline: 3.27x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Wellspan Ephrata Community Hospital is $798. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $994. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.27x the Medicare baseline. Located in 169 Martin Avenue, Ephrata, PA.
Cash / Self-Pay
$994

Average discount available for prompt cash payment at this facility.

Insurance Median
$798

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: $994 (408%)
Insurance Median: $798 (327%)
Cash: $994 (408% of Medicare)
Ins. Median: $798 (327% 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 327% of the Medicare baseline (a markup of 227%). 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
Medicaid / KanCare $143 - $409 59%
Medicare (plans) $219 - $252 90%
Aetna $240 - $962 98%
Highmark $362 - $1,071 149%
Blue_Cross $560 - $800 230%
Cigna $732 - $793 300%
Wellspan_Capital_Blue_Cross $796 327%
Geisinger $808 331%
Independence_Blue_Cross $808 331%
Tower Health $808 - $851 331%
Upmc $808 - $994 331%
Phc $870 - $883 357%
First_Health_Network $1,058 434%
United_Healthcare $1,172 481%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 169 Martin Avenue, Ephrata, PA 17522
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals