CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St John's Riverside Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $296
Cash Discount Price: $1,681
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St John's Riverside Hospital is $296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,681. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.21x the Medicare baseline. Located in 976 North Broadway, Yonkers, NY.

Cash / Self-Pay

$1,681

Average discount available for prompt cash payment at this facility.

Insurance Median

$296

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: $1,681 (690%)

Insurance Median: $296 (121%)

Cash: $1,681 (690% of Medicare)

Ins. Median: $296 (121% 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
Fidelis Essential Plans	$252	103%
Medicaid / KanCare	$252	103%
Fidelis Health Benefit Exchange	$282	116%
Aetna	$296 - $3,783	121%
Centers Plan For Healthy Living	$296	121%
Fidelis	$296	121%
Healthfirst	$296	121%
Hip Health Plan	$296	121%
Magnacare	$296	121%
Medicare (plans)	$296	121%
Mvp	$296	121%
Mvp Bhs	$296	121%
Oscar	$296 - $311	121%
Partners Health Plan	$296	121%
United Behavioral Health Of Ny Ipa	$296	121%
Village Caremax	$296	121%
Wellcare	$296	121%
Metroplus Gold	$311	128%
Emblem Health	$753 - $794	309%
Empire Hmo	$904	371%
UnitedHealthcare	$1,037 - $1,042	425%
Mvp Individual Exchange.Student Health Plan	$1,043	428%
Cigna	$1,224	502%
Mvp Commercial	$1,230	505%

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 $1,681.
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 John's Riverside 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.