CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida Orange Park Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,311
Cash Discount Price: $3,122
vs. Medicare Baseline: 5.38x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida Orange Park Hospital is $1,311. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,122. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.38x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

$3,122

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,311

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: $3,122 (1281%)

Insurance Median: $1,311 (538%)

Cash: $3,122 (1281% of Medicare)

Ins. Median: $1,311 (538% 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 538% of the Medicare baseline (a markup of 438%). 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 - $966	66%
Prime Health	$165 - $986	68%
Optimum Healthcare	$260 - $512	107%
Avmed	$371 - $1,708	152%
United	$371 - $2,745	152%
Simply Healthcare	$393 - $939	161%
Oscar	$495 - $976	203%
Positive Healthcare	$681 - $1,342	279%
Cigna	$740 - $1,726	304%
Sunshine State Health Plan	$789 - $1,555	324%
Molina Healthcare	$835 - $1,647	343%
Aetna	$928 - $1,830	381%
Humana	$1,269 - $2,501	521%
Medicare (plans)	$1,392 - $2,745	571%
Plotkin Health	$1,547 - $3,050	635%
Multiplan	$2,414 - $5,185	990%
Evernorth	$2,476 - $4,880	1016%
Evolutions Healthcare	$2,476 - $5,185	1016%
Ppo Next	$2,630 - $5,185	1079%
Novanet	$2,785 - $5,490	1142%

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 $3,122.
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 Orange Park 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.