CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Strong Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $272
Cash Discount Price: $695
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Strong Memorial Hospital is $272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $695. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.12x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$695

Average discount available for prompt cash payment at this facility.

Insurance Median

$272

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: $695 (285%)

Insurance Median: $272 (112%)

Cash: $695 (285% of Medicare)

Ins. Median: $272 (112% 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
Blue Cross Blue Shield	$109 - $815	45%
Excellus [2201]	$109	45%
Medicaid / KanCare	$109 - $259	45%
Molina Healthcare [1723], Molina Healthcare [5189]	$109	45%
Molina Healthcare [5189]	$109	45%
UnitedHealthcare	$109 - $485	45%
Mvp [2900]	$131 - $1,005	54%
Aetna	$145 - $484	59%
Excellus Bc/Bs [2201]	$145 - $322	59%
Medicare (plans)	$145 - $396	59%
Fidelis [5155]	$156 - $381	64%
Elderplan [1316]	$170	70%
Icircle [1728]	$170	70%
Martins Point [1205]	$170 - $298	70%
Nascentia [1729]	$170	70%
Humana	$172 - $366	71%
Highmark Bc/Bs Of Western Ny [5143]	$190 - $224	78%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$218 - $599	89%
Independent Health [5156]	$274 - $331	112%
Cigna	$415 - $1,090	170%
Capital District Physicians Health Plan (Cdphp) [5149]	$460 - $616	189%

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 $695.
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 Strong Memorial 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.