CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $298
  • Cash Discount Price: $1,006
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Montefiore Mount Vernon Hospital is $298. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,006. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.22x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$1,006

Average discount available for prompt cash payment at this facility.

Insurance Median
$298

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: $1,006 (413%)
Insurance Median: $298 (122%)
Cash: $1,006 (413% of Medicare)
Ins. Median: $298 (122% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Emblem $109 - $1,238 45%
Fidelis $109 - $298 45%
Healthfirst $109 - $298 45%
Medicaid / KanCare $109 45%
Wellcare $110 - $304 45%
Vnsny Choice $125 - $298 51%
Vnsny Select Health $125 51%
American Postal Workers $166 68%
UnitedHealthcare $166 - $298 68%
Metroplus $209 - $387 86%
Blue Cross Blue Shield $298 - $1,238 122%
Point Comfort $298 122%
Villagecaremax $298 122%
Centerlight $307 - $328 126%
Elderplan $307 126%
Partners Health Plan $313 128%
Longevity $325 133%
Humana $328 135%
Molina Healthcare Of Ny Affinity $411 169%
Cigna $826 - $918 339%
Northwell $1,006 413%
Oscar $1,183 485%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals