CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Christopher's Hospital for Children

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,618
Cash Discount Price: $3,065
vs. Medicare Baseline: 6.64x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Christopher's Hospital for Children is $1,618. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,065. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.64x the Medicare baseline. Located in 160 East Erie Ave, Philadelphia, PA.

Cash / Self-Pay

$3,065

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,618

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: $3,065 (1257%)

Insurance Median: $1,618 (664%)

Cash: $3,065 (1257% of Medicare)

Ins. Median: $1,618 (664% 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 664% of the Medicare baseline (a markup of 564%). 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
Health Partners	$108 - $1,376	44%
Geisinger	$139 - $2,758	57%
Amerihealth Caritas	$143	59%
PA Health & Wellness	$154	63%
UnitedHealthcare	$171	70%
Aetna	$200 - $4,598	82%
UPMC	$206	85%
Keystone First	$216	89%
Gateway	$254	104%
Blue Cross Blue Shield	$1,079 - $3,424	443%
Wellpoint Nj (Formerly Amerigroup)	$1,624	666%
Cigna	$1,716	704%
Horizon Nj Health	$2,452	1006%

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 $3,065.
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 Christopher's Hospital for Children 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.