CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Lehigh Valley Hospital - Macungie

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $253
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Lehigh Valley Hospital - Macungie is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.04x the Medicare baseline. Located in 3369 State Route 100, Macungie, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$253

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%)

Insurance Median: $253 (104%)

Ins. Median: $253 (104% 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
Blue Cross Blue Shield	$108 - $246	44%
Highmark Blue Shield	$109 - $662	45%
Humana	$109 - $249	45%
Amerihealth	$112 - $253	46%
Cigna	$112 - $253	46%
Geisinger	$112 - $1,082	46%
Aetna	$114 - $1,229	47%
Jefferson Health Partners	$114 - $492	47%
Upmc	$115 - $1,199	47%
Gateway	$116 - $263	48%
Emblem	$117 - $1,098	48%
Pa Health & Wellness (Allwell)	$119 - $271	49%
Highmark Wholecare/Gateway	$127 - $186	52%
Pa Health & Wellness	$135 - $198	55%
Amerihealth Caritas	$145 - $213	59%
Ambetter / Centene	$328 - $746	135%
Valley Preferred	$631 - $1,435	259%

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 $X.
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 Lehigh Valley Hospital - Macungie 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.