CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida Palms West Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,279
Cash Discount Price: $5,813
vs. Medicare Baseline: 5.25x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida Palms West Hospital is $1,279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,813. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.25x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.

Cash / Self-Pay

$5,813

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,279

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: $5,813 (2385%)

Insurance Median: $1,279 (525%)

Cash: $5,813 (2385% of Medicare)

Ins. Median: $1,279 (525% 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 525% of the Medicare baseline (a markup of 425%). 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 - $1,014	71%
Careworks (Rockport)	$177 - $1,036	73%
Prime Health	$177 - $1,036	73%
Freedom Health	$500 - $930	205%
Optimum	$500	205%
Healthy Palm Beaches	$550	226%
Avmed	$756 - $2,906	310%
Simply Healthcare Plans	$756	310%
Simply Healthcare	$785	322%
Oscar	$930	382%
Amerihealth Caritas	$988	405%
Molina	$1,104 - $1,570	453%
Cigna	$1,221	501%
Humana	$1,221 - $1,976	501%
Health Sun Health Plan	$1,238	508%
Aids Healthcare	$1,279 - $6,976	525%
Mmm Of Fl (Health Advantage Plan)	$1,337	548%
United Ppo	$1,378	565%
Sunshine State Health Plan	$1,511	620%
Aetna	$1,744	715%
United	$2,616	1073%
Health Care District	$2,906	1192%
Palm Beach Juvenile Correction	$2,906	1192%
Plotkin Health	$2,906	1192%
Prime Health Sherriff	$2,906	1192%
Medica Healthcare	$3,372	1383%
Multiplan	$4,360 - $4,941	1789%

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 $5,813.
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 Palms 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.