CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Highland Hospital

Billing Code: 93970 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$208

about 0.9× the $244 Medicare rate · typically $90–$432

modeled estimate · not a bill or quote

What this hospital charges insurers

$325

Above the fair price

about $117 over the fair price · 1.3× Medicare

Medicare pays $244 Fair price $208 This hospital $325 Hospital's list price $909

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $109 Priciest $325

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Ultrasound, leg veins (duplex) is about $208 (about 0.9× the $244 Medicare rate). Highland Hospital charges insurers about $325 — above the fair price. Located in Rochester, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $208. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$109 - $485	45%
Blue Cross Blue Shieldmajor	$109 - $599	45%
Aetnamajor	$145 - $484	59%
Cignamajor	$415 - $893	170%
Humanamajor	$172 - $366	71%
Amerigroup	$109	45%
CDPHP	$460 - $616	189%
Fidelis Care	$156 - $381	64%
Independent Health	$274 - $331	112%
Molina	$109	45%
MVP Health Care	$124 - $850	51%
+ 4 smaller / regional plans	$170 - $298

Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 93970.

Insurance Before you use insurance

Call your insurance company to confirm Highland Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 93970.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Highland Hospital

Compare: Ultrasound, leg veins (duplex) at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.