CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: HCA Florida Poinciana Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $993
Cash Discount Price: $3,709
vs. Medicare Baseline: 4.07x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at HCA Florida Poinciana Hospital is $993. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,709. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.07x the Medicare baseline. Located in 325 Cypress Pkwy, Kissimmee, FL.

Cash / Self-Pay

$3,709

Average discount available for prompt cash payment at this facility.

Insurance Median

$993

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: $3,709 (1522%)

Insurance Median: $993 (407%)

Cash: $3,709 (1522% of Medicare)

Ins. Median: $993 (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 - $967	66%
Prime Health	$165 - $988	68%
Careworks (Rockport Community)	$170 - $1,018	70%
Freedom Health	$257 - $277	105%
Optimum	$257 - $277	105%
Avmed	$285 - $1,926	117%
Simply	$549 - $593	225%
Oscar	$571 - $616	234%
Simply Healthcare	$596 - $643	244%
Cigna	$621 - $670	255%
Molina Healthcare	$678 - $1,040	278%
Evolutions	$820 - $886	336%
Sunshine State Health Plan	$909 - $982	373%
Humana	$999 - $1,079	410%
Aetna	$1,070 - $1,156	439%
United	$1,170 - $1,733	480%
Plotkin Health	$1,783 - $1,926	731%
Prime Health Sheriff	$1,783 - $1,926	731%
Multiplan	$2,675 - $3,274	1097%

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 $3,709.
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 Poinciana 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.