CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida Citrus Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,568
Cash Discount Price: $11,413
vs. Medicare Baseline: 10.53x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida Citrus Hospital is $2,568. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,413. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.53x the Medicare baseline. Located in 502 W Highland Blvd, Inverness, FL.

Cash / Self-Pay

$11,413

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,568

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: $11,413 (4682%)

Insurance Median: $2,568 (1053%)

Cash: $11,413 (4682% of Medicare)

Ins. Median: $2,568 (1053% 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 1053% of the Medicare baseline (a markup of 953%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$536	220%
Access 2 Healthcare Physicians Freedom Health	$685	281%
Access 2 Healthcare Physicians Optimum	$685	281%
Freedom Health Care	$742	304%
Optimum Healthcare	$742	304%
Corvel Corporation	$912	374%
Rockport Healthcare Group	$912	374%
Avmed	$913 - $2,853	375%
Prime Health	$932	382%
Simply Healthcare	$1,449	594%
Oscar	$1,712	702%
United	$1,872 - $5,136	768%
Cigna	$1,986	815%
Molina	$2,168 - $3,081	889%
Evolutions Healthcare Systems	$2,625 - $10,500	1077%
Sunshine State Health Plan	$2,910	1194%
Humana	$3,196	1311%
Aetna	$3,424	1405%
Beacon Health Options	$5,706	2341%
Plotkin Health	$5,706	2341%
Prime Health Sheriff	$5,706	2341%
Multiplan	$8,560 - $9,701	3512%
Evernorth	$9,130	3745%

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 $11,413.
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 HCA Florida Citrus 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.