CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Elizabethtown Community Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $264
Cash Discount Price: $278
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Elizabethtown Community Hospital is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $278. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.08x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$278

Average discount available for prompt cash payment at this facility.

Insurance Median

$264

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: $278 (114%)

Insurance Median: $264 (108%)

Cash: $278 (114% of Medicare)

Ins. Median: $264 (108% 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
Capital District Physicians' Health Plan	$116 - $1,007	48%
UnitedHealthcare	$119 - $1,128	49%
Fidelis Care	$145 - $466	59%
Mvp	$145 - $957	59%
Blue Cross Blue Shield	$151 - $921	62%
Humana	$162 - $230	66%
Aetna	$170 - $919	70%
Martins Point	$170 - $466	70%
Veterans Affairs Community Care Network	$170 - $466	70%
Choicecare	$187 - $980	77%
Harvard Pilgrim	$222 - $980	91%
Magnacare	$222 - $980	91%
Coventry	$236 - $1,041	97%
Wellpath	$238 - $698	98%
Highmark Blueshield	$250 - $998	103%
Multiplan	$250 - $1,102	103%
Emblem Health	$980	402%

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 $278.
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 Elizabethtown Community 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.