CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Winter Haven Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $844
Cash Discount Price: $1,094
vs. Medicare Baseline: 3.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Winter Haven Hospital is $844. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,094. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.46x the Medicare baseline. Located in 200 Ave F Ne, Winter Haven, FL.

Cash / Self-Pay

$1,094

Average discount available for prompt cash payment at this facility.

Insurance Median

$844

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: $1,094 (449%)

Insurance Median: $844 (346%)

Cash: $1,094 (449% of Medicare)

Ins. Median: $844 (346% 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 346% of the Medicare baseline (a markup of 246%). 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
Clear Health Alliance	$106	43%
UnitedHealthcare	$107 - $1,641	44%
Humana	$109 - $303	45%
Freedom Health	$111	46%
Molina Healthcare	$111	46%
Simply Healthcare	$111 - $328	46%
Sunshine Health	$111	46%
Aetna	$113 - $1,486	46%
Florida Community Care	$116	48%
Baycareplus	$243	100%
Blue Cross Blue Shield	$243 - $1,051	100%
Careplus	$252	103%
Solis Health	$267	110%
Freedom	$271	111%
Optimum	$271	111%
Cigna	$279 - $1,586	114%
Health First	$279	114%
Molina	$328 - $1,077	135%
Wellcare	$340	139%
Ambetter / Centene	$546 - $1,823	224%
Ultimate Health Plan	$547	224%
Avmed	$565 - $893	232%
Florida Hospital	$839	344%
Evolutions	$912 - $1,695	374%
Multiplan	$1,458	598%
First Health	$1,550	636%
United Behavioral Health	$1,823	748%

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 $1,094.
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 Winter Haven 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.