CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: UPMC Muncy

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,138
Cash Discount Price: $1,228
vs. Medicare Baseline: 4.67x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at UPMC Muncy is $1,138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,228. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.67x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$1,228

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,138

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: $1,228 (504%)

Insurance Median: $1,138 (467%)

Cash: $1,228 (504% of Medicare)

Ins. Median: $1,138 (467% 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 467% of the Medicare baseline (a markup of 367%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$146 - $1,399	60%
Geisinger	$161 - $1,371	66%
Upmc Health Plan	$161 - $892	66%
Highmark Wholecare (Prev Gateway)	$164 - $307	67%
Amerihealth Caritas	$165 - $2,208	68%
Pa Health & Wellness	$250 - $2,316	103%
Cigna	$315 - $1,402	129%
Upmc Work Partners	$461	189%
Three Rivers Provider Network	$493 - $1,841	202%
Blue Cross Blue Shield	$784 - $945	322%
Aetna	$810 - $1,350	332%
Coventry/First Health	$1,001 - $1,377	411%
Wirerope Works	$1,111 - $1,138	456%
Multiplan	$1,558 - $1,944	639%
America'S Choice	$1,598 - $1,637	656%
Intergroup	$1,598 - $1,637	656%

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 $1,228.
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 Muncy 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.