CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida West Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,872
Cash Discount Price: $4,679
vs. Medicare Baseline: 7.68x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida West Hospital is $1,872. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,679. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.68x the Medicare baseline. Located in 8383 N Davis Hwy, Pensacola, FL.

Cash / Self-Pay

$4,679

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,872

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: $4,679 (1919%)

Insurance Median: $1,872 (768%)

Cash: $4,679 (1919% of Medicare)

Ins. Median: $1,872 (768% 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 768% of the Medicare baseline (a markup of 668%). 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 - $928	66%
Prime Health	$165 - $948	68%
Careworks (Rockport Community)	$170 - $977	70%
Oscar	$510 - $571	209%
Freedom Health	$589 - $659	242%
Simply	$714 - $799	293%
Simply Healthcare	$775 - $867	318%
Cigna	$807 - $2,154	331%
Molina Healthcare	$881 - $1,661	361%
Humana	$928 - $1,038	381%
United	$997 - $2,335	409%
Avmed	$1,113 - $2,595	457%
Sunshine State Health Plan	$1,183 - $1,323	485%
Aetna	$1,392 - $1,557	571%
Pensacola Christian	$1,856 - $2,076	761%
Plotkin Health	$2,320 - $2,595	952%
Prime Health Sheriff	$2,320 - $2,595	952%
Evolutions Healthcare	$3,016 - $4,411	1237%
Multiplan	$3,619 - $4,411	1485%
Evernorth	$3,711 - $4,152	1522%
Ppo Next	$3,943 - $4,411	1618%
Novanet	$4,175 - $4,671	1713%
Beacon Health Options	$4,639 - $5,190	1903%

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 $4,679.
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 West 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.