CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Hialeah Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93970
  • Insurance Median: $241
  • Cash Discount Price: $2,464
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Hialeah Hospital is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,464. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.99x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$2,464

Average discount available for prompt cash payment at this facility.

Insurance Median
$241

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: $2,464 (1011%)
Insurance Median: $241 (99%)
Cash: $2,464 (1011% of Medicare)
Ins. Median: $241 (99% 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.

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 $74 - $1,774 30%
Humana $106 - $1,129 43%
Medicaid / KanCare $106 - $111 43%
UnitedHealthcare $108 - $764 44%
Bc/Bs Of Fl Miami Dade Blue Select $148 61%
Oscar Health Plan Hix $151 62%
Veterans Administration Mill Bill $164 67%
Avmed Broad Network $187 77%
Bc/Bs Of Fl Health Options Hmo $192 79%
Bc/Bs Of Fl Network Blue $192 79%
Healthsun Health Plans $193 - $246 79%
Bc/Bs Myblue Hmo Hix $196 80%
Bc/Bs Of Fl Ppo $203 83%
Bc/Bs Of Fl Simplyblue $206 85%
Medicare (plans) $211 - $511 87%
Bc/Bs Of Fl Blue Select Exchange Non Par $214 88%
Self Pay/Uninsured $230 - $292 94%
Leon Health Inc $233 96%
Devoted Health $234 96%
Employer Direct Healthcare $234 - $238 96%
Tricare $235 96%
Bristol Hospice- Miami Dade Llc $238 98%
Catholic Hospice $238 98%
Comprehensive Home Health Care Dba Opuscare Of South Florida $238 98%
Hcr Manor Care Services Of Fl $238 98%
Hospice Other $238 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $238 98%
Seasons Hospice And Pallative Care Of Southern Florida Inc $238 98%
Veterans Administration Vaccn $238 98%
Vitas Healthcare Hospice Corporation Of Fl $238 98%
Vitas Hospice Unit Agreement $238 98%
Cigna $246 - $725 101%
Imagine Health $246 101%
Longevity Health Plan $248 102%
Florida Pace Centers $281 115%
Bright Health Management Commercial $285 117%
Naphcare Inc $328 135%
Avmed Exchange $416 171%
Ambetter / Centene $440 180%
Molina Marketplace Program Exchange $453 186%
Auto Insurance $476 195%
Avmed Select Network $487 200%
Amerihealth Caritas Next Exchange $511 210%
Bc/Bs Of Fl Phs $1,278 524%
Dimensions International $1,602 657%
First Health $1,676 688%
Dimension Health Ppo $1,848 758%
Dimension Health Wc $1,848 758%
Workers Compensation $1,848 758%
Commercial Non-Contracted $2,464 1011%
Self Pay - Mcd Pending 100 Percent $2,464 1011%
Single Case Agreement $2,464 1011%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals