CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida Aventura Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $535
Cash Discount Price: $2,056
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida Aventura Hospital is $535. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,056. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.19x the Medicare baseline. Located in 20900 Biscayne Blvd, Aventura, FL.

Cash / Self-Pay

$2,056

Average discount available for prompt cash payment at this facility.

Insurance Median

$535

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: $2,056 (843%)

Insurance Median: $535 (219%)

Cash: $2,056 (843% of Medicare)

Ins. Median: $535 (219% 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 219% of the Medicare baseline (a markup of 119%). 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	$177 - $1,053	73%
Freedom Health	$177 - $329	73%
Optimum	$177	73%
Careworks (Rockport)	$180 - $1,075	74%
Prime Health	$180 - $1,075	74%
Avmed	$247 - $1,028	101%
Simply Healthcare Plans	$267	110%
Simply Healthcare	$278	114%
Oscar	$329	135%
Amerihealth Caritas	$350	144%
Molina	$350 - $555	144%
Cigna	$432	177%
Humana	$432 - $699	177%
Health Sun Health Plan	$438	180%
Aids Healthcare	$452 - $2,467	185%
Mmm Of Fl (Health Advantage Plan)	$473	194%
United Ppo	$487	200%
Sunshine State Health Plan	$535	219%
Aetna	$617	253%
United	$925	379%
Plotkin Health	$1,028	422%
Prime Health Sherriff	$1,028	422%
Medica Healthcare	$1,192	489%
Multiplan	$1,542 - $1,748	633%
Evernorth Bh	$1,645	675%

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 $2,056.
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 Aventura 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.