CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Marion Communtiy Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,865
Cash Discount Price: $7,706
vs. Medicare Baseline: 7.65x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Marion Communtiy Hospital is $1,865. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,706. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.65x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.

Cash / Self-Pay

$7,706

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,865

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: $7,706 (3161%)

Insurance Median: $1,865 (765%)

Cash: $7,706 (3161% of Medicare)

Ins. Median: $1,865 (765% 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 765% of the Medicare baseline (a markup of 665%). 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 - $921	66%
Prime Health	$165 - $941	68%
Careworks (Rockport Community)	$170 - $970	70%
Marion County Schools	$170 - $970	70%
Avmed	$890 - $2,239	365%
Simply Healthcare	$942 - $1,016	386%
Simply	$1,142 - $1,232	468%
Cigna	$1,290 - $3,327	529%
United	$1,290 - $3,599	529%
Molina Healthcare	$1,409 - $2,559	578%
Humana	$1,483 - $1,599	608%
Evolutions	$1,706 - $1,839	700%
Evolutions Healthcare	$1,706 - $1,839	700%
Sunshine State Health Plan	$1,891 - $2,039	776%
Aetna	$2,225 - $2,399	913%
Plotkin Health	$3,708 - $3,998	1521%
Prime Health Sheriff	$3,708 - $3,998	1521%
Multiplan	$5,784 - $6,238	2373%
Ppo Next	$6,303 - $6,797	2586%
Novanet	$6,674 - $7,197	2738%

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 $7,706.
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 Marion Communtiy 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.