CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida Englewood Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $991
Cash Discount Price: $4,749
vs. Medicare Baseline: 4.07x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida Englewood Hospital is $991. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,749. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.07x the Medicare baseline. Located in 700 Medical Blvd, Englewood, FL.

Cash / Self-Pay

$4,749

Average discount available for prompt cash payment at this facility.

Insurance Median

$991

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: $4,749 (1948%)

Insurance Median: $991 (407%)

Cash: $4,749 (1948% of Medicare)

Ins. Median: $991 (407% 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 407% of the Medicare baseline (a markup of 307%). 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 - $981	66%
Rockport Healthcare Group	$162 - $981	66%
Prime Health	$165 - $1,001	68%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$223	91%
Access 2 Healthcare Physicians Freedom Health	$342	140%
Access 2 Healthcare Physicians Optimum	$342	140%
Freedom Health Care	$370	152%
Optimum Healthcare	$370	152%
Avmed	$380 - $1,187	156%
Simply Healthcare	$698 - $731	286%
Oscar	$712	292%
United	$779 - $2,137	320%
Cigna	$826	339%
Molina	$902 - $1,282	370%
Evolutions Healthcare Systems	$1,092 - $4,369	448%
Sunshine State Health Plan	$1,211	497%
Humana	$1,330	546%
Aetna	$1,425	585%
Behealthy America	$1,852	760%
Healthcare Sarasota	$2,374	974%
Plotkin Health	$2,374	974%
Prime Health Sheriff	$2,374	974%
Multiplan	$3,561 - $4,036	1461%

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 $4,749.
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 Englewood 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.