CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Margaretville Memorial Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $1,403
  • Cash Discount Price: $2,159
  • vs. Medicare Baseline: 5.76x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Margaretville Memorial Hospital is $1,403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,159. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.76x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$2,159

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,403

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: $2,159 (886%)
Insurance Median: $1,403 (576%)
Cash: $2,159 (886% of Medicare)
Ins. Median: $1,403 (576% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 576% of the Medicare baseline (a markup of 476%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $435 - $32,500 178%
Emblem $552 - $651 226%
Mvp $645 265%
UnitedHealthcare $736 - $22,000 302%
Mvp Hmo/Ppo $761 312%
Oxford $779 - $866 320%
Blue Cross Blue Shield $858 - $22,000 352%
Medicare (plans) $950 - $23,540 390%
Hamaspik (McR) $950 - $22,000 390%
Mvp Gold (McR) $950 - $22,000 390%
Affinity By Molina McR $997 - $23,100 409%
Cdphp $1,045 - $24,200 429%
Oxford Exchange $1,080 443%
Self-Pay $1,177 483%
Mvp Exchange $1,403 576%
Emblem Select Care (Exchange) $1,468 602%
Magnacare Standard $1,511 620%
Emblem Ghi/Hip Ppo/Cbp $1,554 637%
Todays Options $1,567 643%
Emblem Ghi/Hip Hmo/Epo/Pos $1,727 708%
Magnacare Preferred $1,727 708%
Multiplan $1,770 726%
First Health $1,943 797%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 42084 State Highway 28, Margaretville, NY 12455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals