CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $243
Cash Discount Price: $595
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Cleveland Clinic Indian River Hospital is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $595. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$595

Average discount available for prompt cash payment at this facility.

Insurance Median

$243

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: $595 (244%)

Insurance Median: $243 (100%)

Cash: $595 (244% of Medicare)

Ins. Median: $243 (100% 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
Aetna	$114 - $1,262	47%
UnitedHealthcare	$134	55%
Amerihealth	$141	58%
Medicaid / KanCare	$141	58%
Molina	$141	58%
Value Options	$141 - $181	58%
Wellcare	$141 - $243	58%
Clarity Health	$164 - $1,025	67%
The Legacy Companies	$164 - $1,025	67%
National Provider Network	$177	73%
Three Rivers	$177	73%
Avmed	$181 - $556	74%
Blue Cross Blue Shield	$181 - $764	74%
Careplus	$181 - $243	74%
Magellan	$181 - $946	74%
United	$181 - $634	74%
Consociate Health	$190	78%
Freedom Health	$190 - $243	78%
Independent Living Systems	$190 - $255	78%
Wellmed	$190 - $243	78%
Clear Spring Health	$195 - $267	80%
Cigna	$203 - $473	83%
Carelon Bh Strategies	$243	100%
Humana	$243	100%
Devoted Health	$267	110%
Bmi	$867	356%
Multiplan	$1,262	518%

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 $595.
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 Cleveland Clinic Indian River 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.