CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Children's Hospital of Philadelphia

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,121
Cash Discount Price: $6,339
vs. Medicare Baseline: 8.70x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Children's Hospital of Philadelphia is $2,121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,339. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.70x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$6,339

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,121

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: $6,339 (2600%)

Insurance Median: $2,121 (870%)

Cash: $6,339 (2600% of Medicare)

Ins. Median: $2,121 (870% 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 870% of the Medicare baseline (a markup of 770%). 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
Geisinger Medical Assistance	$154	63%
Highmark Wholecare	$171	70%
UnitedHealthcare	$430 - $1,052	176%
Geisinger Health Plan Commercial	$869	356%
Medicaid / KanCare	$1,046	429%
Horizon Nj Health	$1,155	474%
Health Partners	$1,195	490%
Aetna	$1,668 - $3,170	684%
Upmc Medical Assistance	$1,731	710%
Keystone First Chip	$1,965	806%
Keystone Health Plan East	$2,004	822%
Blue Cross Blue Shield	$2,238 - $2,539	918%
Jefferson Health Plans	$2,998	1230%
Cigna	$3,170	1300%
Highmark	$3,170	1300%
Qualcare	$3,487	1430%
First Health Network	$4,120	1690%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$5,071	2080%
Private Health Care Systems	$5,071	2080%
Choice Care Network	$5,705	2340%

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 $6,339.
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 Children's Hospital of Philadelphia 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.