CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $765
Cash Discount Price: $1,866
vs. Medicare Baseline: 3.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Nemours Childrens Hospital, Florida is $765. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,866. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.14x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$1,866

Average discount available for prompt cash payment at this facility.

Insurance Median

$765

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: $1,866 (765%)

Insurance Median: $765 (314%)

Cash: $1,866 (765% of Medicare)

Ins. Median: $765 (314% 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 314% of the Medicare baseline (a markup of 214%). 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
Tricare	$243	100%
Aetna	$399 - $821	164%
Cigna	$434 - $754	178%
Truli	$546 - $746	224%
Avmed	$578	237%
Florida Blue	$607 - $1,151	249%
UnitedHealthcare	$634	260%
Employers Health Network Fl	$746	306%
Evolutions Healthcare	$840	345%
Integra Administrative Group	$1,120	459%
Global Medical Management	$1,213	498%
Prime Health Services	$1,213	498%
Star Healthcare Network	$1,213	498%
Velocity	$1,400	574%
First Health Network	$1,455	597%
Pnoa	$1,493	612%
Seminole Tribe Of Fl	$1,493	612%
Private Healthcare Systems	$1,717	704%

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 $1,866.
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 Nemours Childrens Hospital, Florida 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.