CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Glens Falls Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $253
Cash Discount Price: $329
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Glens Falls Hospital is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $329. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.04x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$329

Average discount available for prompt cash payment at this facility.

Insurance Median

$253

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: $329 (135%)

Insurance Median: $253 (104%)

Cash: $329 (135% of Medicare)

Ins. Median: $253 (104% 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.

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
Aetna	$34 - $670	14%
Blue Shield	$96 - $544	39%
Mvp Commercial	$98 - $618	40%
Cdphp	$116 - $1,749	48%
Medicare (plans)	$128 - $170	53%
UnitedHealthcare	$128 - $760	53%
Blue Cross Blue Shield	$140 - $777	57%
Emblem Health Ghi	$145 - $170	59%
Medicaid / KanCare	$149 - $173	61%
Tricare	$166 - $170	68%
Fidelis	$170 - $1,749	70%
Mvp	$171 - $1,632	70%
Blue Shield Highmark	$253 - $529	104%
Cigna	$267 - $323	110%
Magnacare	$286 - $670	117%
Empire Plan Nyship	$302 - $760	124%
Hamaspik	$302 - $581	124%
Nascentia Health Options	$302 - $581	124%
Emblem	$372 - $715	153%
Multiplan	$395 - $760	162%

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 $329.
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 Glens Falls Hospital 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.