CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida Osceola Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,822
Cash Discount Price: $6,404
vs. Medicare Baseline: 7.47x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida Osceola Hospital is $1,822. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,404. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.47x the Medicare baseline. Located in 700 West Oak Street, Kissimmee, FL.

Cash / Self-Pay

$6,404

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,822

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: $6,404 (2627%)

Insurance Median: $1,822 (747%)

Cash: $6,404 (2627% of Medicare)

Ins. Median: $1,822 (747% 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 747% of the Medicare baseline (a markup of 647%). 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
Corvel Corporation	$162 - $967	66%
Prime Health	$165 - $988	68%
Careworks (Rockport Community)	$170 - $1,018	70%
Freedom Health	$443 - $479	182%
Optimum	$443 - $479	182%
Avmed	$492 - $3,327	202%
Simply	$948 - $1,025	389%
Oscar	$985 - $1,065	404%
Simply Healthcare	$1,028 - $1,111	422%
Cigna	$1,071 - $1,158	439%
Molina Healthcare	$1,169 - $1,796	480%
Evolutions	$1,416 - $1,530	581%
Sunshine State Health Plan	$1,570 - $1,697	644%
Humana	$1,723 - $1,863	707%
Aetna	$1,847 - $1,996	758%
United	$2,056 - $2,994	843%
Plotkin Health	$3,078 - $3,327	1263%
Prime Health Sheriff	$3,078 - $3,327	1263%
Multiplan	$4,616 - $5,656	1894%
Evernorth	$4,924 - $5,323	2020%
Ppo Next	$5,232 - $5,656	2146%
Novanet	$5,540 - $5,988	2273%
Beacon Health Options	$6,155 - $6,654	2525%

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 $6,404.
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 Osceola 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.