CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Montefiore St Luke's Cornwall

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $357
Cash Discount Price: $298
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Montefiore St Luke's Cornwall is $357. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $298. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.46x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

$298

Average discount available for prompt cash payment at this facility.

Insurance Median

$357

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: $298 (122%)

Insurance Median: $357 (146%)

Cash: $298 (122% of Medicare)

Ins. Median: $357 (146% 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
Affinity	$109 - $313	45%
Emblem	$109 - $2,992	45%
Healthfirst	$109 - $1,442	45%
Medicaid / KanCare	$109	45%
Fidelis	$238 - $345	98%
Mediblue	$289	119%
Aetna	$295 - $2,566	121%
Blue Cross Blue Shield	$298 - $2,655	122%
Cdphp	$298	122%
Hudson Valley	$298	122%
Oscar	$298 - $2,524	122%
Point Comfort	$298	122%
UnitedHealthcare	$298	122%
Villagecaremax	$298	122%
Vnsny Choice	$298	122%
Centerlight	$307	126%
Wellcare	$307	126%
Hamaspik	$322	132%
Humana	$328	135%
Geha	$367 - $2,566	151%
Meritain Health	$367 - $2,566	151%
Nippon Life Insurance	$367 - $2,566	151%
Northwell	$801 - $2,431	329%
Cigna	$2,143 - $2,381	879%
Centivo	$2,356	966%
Magnacare	$2,805	1151%

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 $298.
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 Montefiore St Luke's Cornwall 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.