CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida North Florida Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,899
Cash Discount Price: $6,331
vs. Medicare Baseline: 7.79x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida North Florida Hospital is $1,899. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,331. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.79x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$6,331

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,899

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: $6,331 (2597%)

Insurance Median: $1,899 (779%)

Cash: $6,331 (2597% of Medicare)

Ins. Median: $1,899 (779% 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 779% of the Medicare baseline (a markup of 679%). 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 - $1,020	66%
Prime Health	$165 - $1,042	68%
Careworks (Rockport Community)	$170 - $1,074	70%
Avmed	$760 - $3,166	312%
Oscar	$760	312%
Simply Healthcare	$804	330%
United	$950 - $2,849	390%
Simply	$975	400%
Cigna	$1,102 - $2,634	452%
Molina Healthcare	$1,203 - $2,026	493%
Humana	$1,266	519%
Evolutions	$1,456	597%
Sunshine State Health Plan	$1,615	663%
Aetna	$1,899	779%
Plotkin Health	$3,166	1299%
Prime Health Sheriff	$3,166	1299%
Corizon Phs	$3,799	1558%
Multiplan	$4,939 - $5,382	2026%
Evernorth	$5,065	2078%
Evolutions Healthcare	$5,382	2208%
Ppo Next	$5,382	2208%
Novanet	$5,698	2337%
Beacon Health Options	$6,331	2597%

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 $6,331.
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 North Florida 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.