CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: St Lucie Medical Center

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $2,296
Cash Discount Price: $8,831
vs. Medicare Baseline: 9.42x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at St Lucie Medical Center is $2,296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,831. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.42x the Medicare baseline. Located in 1800 Se Tiffany Ave, Port Saint Lucie, FL.

Cash / Self-Pay

$8,831

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,296

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: $8,831 (3623%)

Insurance Median: $2,296 (942%)

Cash: $8,831 (3623% of Medicare)

Ins. Median: $2,296 (942% 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 942% of the Medicare baseline (a markup of 842%). 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	$173 - $1,006	71%
Careworks (Rockport)	$177 - $1,028	73%
Prime Health	$177 - $1,028	73%
Freedom Health	$759 - $1,413	311%
Optimum	$759	311%
Avmed	$1,148 - $4,416	471%
Simply Healthcare Plans	$1,148	471%
Molina	$1,678 - $2,384	688%
Oscar	$1,678	688%
Health Sun Health Plan	$1,881	772%
Simply Healthcare	$2,075	851%
Sunshine State Health Plan	$2,252	924%
Cigna	$2,323 - $3,100	953%
Aetna	$2,649	1087%
Humana	$3,267 - $3,532	1340%
United Ppo	$3,886	1594%
United	$3,974	1630%
Plotkin Health	$4,416	1812%
Prime Health Sherriff	$4,416	1812%
Multiplan	$6,623 - $7,506	2717%

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 $8,831.
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 St Lucie Medical Center 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.