CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: UPMC Hanover

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $442
Cash Discount Price: $820
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at UPMC Hanover is $442. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $820. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.81x the Medicare baseline. Located in 300 Highland Ave, Hanover, PA.

Cash / Self-Pay

$820

Average discount available for prompt cash payment at this facility.

Insurance Median

$442

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: $820 (336%)

Insurance Median: $442 (181%)

Cash: $820 (336% of Medicare)

Ins. Median: $442 (181% 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
UnitedHealthcare	$150 - $801	62%
Amerihealth Caritas	$186	76%
Highmark Wholecare (Prev Gateway)	$186	76%
Upmc Health Plan	$191 - $956	78%
Health Partners Plans (Jefferson Health Plan)	$200	82%
Geisinger	$214 - $987	88%
Blue Cross Blue Shield	$229 - $928	94%
Humana	$231	95%
Aetna	$241 - $994	99%
Cigna	$242 - $1,225	99%
Pa Health & Wellness	$249 - $250	102%
Keystone Health Plan	$260 - $928	107%
Prime Net	$331 - $426	136%
Keystone Autism Services	$369	151%
Upmc Work Partners	$442	181%
Carefirst	$1,161	476%
Multiplan	$1,161	476%
Wellspan Population Health	$1,188	487%

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 $820.
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 Hanover 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.