CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Saratoga Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $38
Cash Discount Price: $1,026
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Saratoga Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,026. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.16x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$1,026

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $1,026 (421%)

Insurance Median: $38 (16%)

Cash: $1,026 (421% of Medicare)

Ins. Median: $38 (16% 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
Cdphp	$21 - $1,736	9%
Fidelis	$23 - $1,736	9%
Medicare (plans)	$23 - $30	9%
Blue Cross Blue Shield	$24 - $1,427	10%
Medicaid / KanCare	$26	11%
Tricare	$26 - $30	11%
Hamaspik	$28 - $1,813	11%
Emblem Health Ghi	$30 - $33	12%
UnitedHealthcare	$30 - $1,939	12%
Aetna	$31 - $1,344	13%
Mvp	$31 - $58	13%
Blue Shield Highmark	$35 - $47	14%
Cigna	$48 - $58	20%
Mvp Commercial	$99 - $1,538	41%
Blue Shield	$129 - $717	53%
Nascentia Health Options	$267	110%
Emblem	$274 - $286	112%
Mvp Essential Plan	$771 - $1,543	316%
Mvp Govt Programs	$771	316%
Empire Plan Nyship	$1,012 - $1,508	415%
Multiplan	$1,264 - $1,831	519%
Magnacare	$1,517 - $2,046	622%

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 $1,026.
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 Saratoga 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.