CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Mary Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $309
Cash Discount Price: $1,070
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Mary Medical Center is $309. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,070. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.27x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.

Cash / Self-Pay

$1,070

Average discount available for prompt cash payment at this facility.

Insurance Median

$309

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: $1,070 (439%)

Insurance Median: $309 (127%)

Cash: $1,070 (439% of Medicare)

Ins. Median: $309 (127% 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
Medicaid / KanCare	$131 - $352	54%
Aetna	$166 - $1,465	68%
UnitedHealthcare	$188 - $871	77%
Pace-Trinity Health	$214	88%
Blue Cross Blue Shield	$257	105%
Cigna	$260 - $1,108	107%
Align Senior Care	$262	107%
Medicare (plans)	$264 - $463	108%
Keystone First	$274 - $352	112%
Keystone First Chip	$274 - $352	112%
Health America Advantra	$309	127%
Ambetter / Centene	$459	188%
Oscar	$463	190%
Prime Healthcare	$463	190%
Jefferson Health Plan Commercial	$468	192%
Homestead Health Plans Woods Center	$502	206%
Group Pension Administrators	$579	238%
Reedman Toll	$579	238%
Blue Shield - Pa (Highmark)	$696	286%
Geha	$871	357%
Upmc Health Plan	$1,108	455%
Webtpa	$1,108	455%
Meritain	$1,465	601%
Multiplan	$1,481	608%
Prime Health Services	$1,481	608%
Galaxy Health Network	$1,564	642%
Three Rivers Provider Network	$1,564	642%

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 $1,070.
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 St Mary Medical Center 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.