How Much Does a Carotid Ultrasound Cost in Pennsylvania?
Extracranial bilat study
$281Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, a carotid ultrasound costs about $281 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Pennsylvania averages $186, from $176 in Rest of Pennsylvania to $197 in Metropolitan Philadelphia.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Pennsylvania Medicare physician rate (2026)
-1.5% vs nationalAverage of 2 localities. Office range $175.77–$196.71.
What the whole procedure costs
The office rate above is what an imaging center, lab or office is paid for the whole test. In a hospital, the facility bills its own fee and the physician bills only the reading. These are 2026 national Medicare amounts.
This is Medicare's separate payment to the facility on top of the physician's fee. For a test like this the physician in a hospital bills only the reading (the professional component); outside a hospital one global fee covers the whole test, shown in the office rate above. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What carotid ultrasound costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 15001.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Pennsylvania the office and hospital physician lines for this CPT differ by $148.62.
National vs Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 93880 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $196.71 |
| rest of pennsylvania | $175.77 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
Carotid Ultrasound and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
This procedure: A bilateral carotid duplex ultrasound examines the arteries on both sides of the neck that supply the brain, measuring plaque buildup and blood flow speed to estimate narrowing. It is ordered after a stroke or mini-stroke, for a bruit heard in the neck, or before certain surgeries. A technologist moves a probe along each side of your neck for 30 to 45 minutes; it is painless, radiation-free, and requires no preparation.
What Is Carotid Ultrasound?
A bilateral carotid duplex ultrasound examines the arteries on both sides of the neck that supply the brain, measuring plaque buildup and blood flow speed to estimate narrowing. It is ordered after a stroke or mini-stroke, for a bruit heard in the neck, or before certain surgeries. A technologist moves a probe along each side of your neck for 30 to 45 minutes; it is painless, radiation-free, and requires no preparation.
What Affects the Cost
- –Hospital vascular labs charge multiples of what office-based or freestanding vascular labs charge for the same bilateral study.
- –Significant narrowing triggers surveillance scans every 6 to 12 months, making the per-scan price a recurring expense for years.
- –Findings can cascade to CT or MR angiography for confirmation, each far more expensive than the ultrasound.
- –The interpreting physician's fee is a separate component at facility-based labs.
- –Screening packages sold directly to consumers by mobile companies price this scan cheaply as cash-pay, but positive findings still funnel into insured follow-up costs.
Questions to Ask Before Booking
- 1.What indication is on my order, and is it one my insurer covers?
- 2.What does this study cost at an office vascular lab versus the hospital?
- 3.If narrowing is found, how often will I need repeat scans and at what cost each?
- 4.Would an abnormal result lead to CT or MR angiography, and what do those cost?
- 5.Is the physician interpretation included in your quoted price?
Other featured procedures in Pennsylvania
Carotid Ultrasound in other states
Carotid Ultrasound in Pennsylvania: questions
Under 2026 Medicare rates, a carotid ultrasound costs about $281 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Pennsylvania averages $186, from $176 in Rest of Pennsylvania to $197 in Metropolitan Philadelphia. Enter a ZIP for the exact Pennsylvania locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $20.94 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $37 for the office physician line or $8 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
It depends on where the test is done. At an independent imaging center, lab or office, $186.24 is Medicare's full rate in Pennsylvania, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $37.62) and the hospital is paid separately, which brings the national total to about $281. Pennsylvania ranks #27 of 51 states on the non-hospital rate (within 2% of the national office rate of $189.05).