CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: PAM Health Specialty Hospital of Pittsburgh

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $875
Cash Discount Price: $1,166
vs. Medicare Baseline: 3.59x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at PAM Health Specialty Hospital of Pittsburgh is $875. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,166. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.59x the Medicare baseline. Located in 7777 Steubenville Pike, Oakdale, PA.

Cash / Self-Pay

$1,166

Average discount available for prompt cash payment at this facility.

Insurance Median

$875

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: $1,166 (478%)

Insurance Median: $875 (359%)

Cash: $1,166 (478% of Medicare)

Ins. Median: $875 (359% 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 359% of the Medicare baseline (a markup of 259%). 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
Molina	$292	120%
America's Choice	$816	335%
Quik Trip	$874	359%
USA Managed Care Organization	$874	359%
Velocity Provider PPO Network	$874	359%
Prime Health Services	$991	407%

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 $1,166.
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 PAM Health Specialty Hospital of Pittsburgh 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.