CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida Lake City Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,292
Cash Discount Price: $4,317
vs. Medicare Baseline: 5.30x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida Lake City Hospital is $1,292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,317. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.30x the Medicare baseline. Located in 340 Nw Commerce Dr, Lake City, FL.

Cash / Self-Pay

$4,317

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,292

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: $4,317 (1771%)

Insurance Median: $1,292 (530%)

Cash: $4,317 (1771% of Medicare)

Ins. Median: $1,292 (530% 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 530% of the Medicare baseline (a markup of 430%). 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 - $909	66%
Prime Health	$165 - $928	68%
Careworks (Rockport Community)	$170 - $957	70%
Avmed	$499 - $2,239	205%
Oscar	$499 - $537	205%
Simply Healthcare	$528 - $569	217%
Simply	$640 - $690	263%
Cigna	$723 - $1,863	297%
Humana	$831 - $895	341%
Evolutions	$956 - $3,806	392%
United	$981 - $2,015	402%
Sunshine State Health Plan	$1,060 - $1,142	435%
Aetna	$1,247 - $1,343	512%
Molina Healthcare	$1,330 - $1,433	546%
Plotkin Health	$2,079 - $2,239	853%
Prime Health Sheriff	$2,079 - $2,239	853%
Hamilton County Jail	$2,245 - $2,418	921%
Multiplan	$3,243 - $3,806	1330%
Ppo Next	$3,534 - $3,806	1450%
Novanet	$3,742 - $4,030	1535%

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 $4,317.
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 Lake City 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.