At Vein Health Clinics, self-pay prices start at $150 for an office visit and $1,000 for a vein ablation or a Varithena treatment. Whether insurance pays for any of it comes down to one question: is this a medical problem or a cosmetic one? Treatment of symptomatic varicose veins caused by documented vein reflux is usually covered. Treatment of spider veins is almost never covered, because insurers classify it as cosmetic. The only way to know which category you’re in is a duplex ultrasound.
The one thing that decides whether insurance pays
Insurers do not decide based on how your legs look. They decide based on two things:
- Are your veins causing medical symptoms? Aching, heaviness, throbbing, swelling, night cramps, skin changes, or a healed or open ulcer.
- Does an ultrasound show the veins are actually failing? Medicare’s Florida coverage policy defines varicose veins as veins 3 mm or larger in diameter with reflux lasting more than 500 milliseconds measured with the patient upright.¹ Reflux means blood flowing backwards down the leg because the valves no longer close.
If both are true, your treatment is a medical procedure. If neither is true — the veins look unattractive but don’t hurt and don’t leak — it’s cosmetic, and you pay for it yourself.
Spider veins are the clearest example. Medicare’s policy states plainly that treatment of telangiectasias (spider veins) is not covered, because it is done for cosmetic reasons.² Most commercial plans follow the same logic. That is why we publish a self-pay price for sclerotherapy: for most people it’s the only price that will ever apply.
⚠️ Important: Spider veins on the surface can sometimes be the visible tip of underlying vein reflux. If you also have aching, swelling or heaviness, ask for an ultrasound before assuming it’s cosmetic — the underlying problem may well be covered even if the surface veins are not.
What insurers typically require before approving treatment
Every plan writes its own rules, but the pattern is consistent across Medicare and most commercial insurers:
- A documented duplex ultrasound showing reflux and vein diameter. This is not optional. It is the single piece of evidence that decides the claim.
- Documented symptoms, in your chart, in your words — what hurts, how much, and how it limits you.
- A trial of conservative therapy first — graduated compression stockings, leg elevation, exercise, weight management — usually over a period of several weeks to a few months, with the dates recorded. If you skip this, the claim gets denied even when the ultrasound is abnormal.
- Photographs, for some plans.
- Prior authorisation for the specific procedure and the specific vein.
There is an important nuance worth knowing. The 2022 clinical practice guidelines from the Society for Vascular Surgery, the American Venous Forum and the American Vein & Lymphatic Society recommend intervention over long-term compression stockings for patients with symptomatic varicose veins and reflux in the great or small saphenous vein (a grade 1, strong recommendation).³ In other words, compression is not the destination — it’s the documented step insurers ask you to pass through on the way to definitive treatment.
The practical takeaway: start the compression trial the day you first see a doctor about your legs, and make sure it’s written down. Patients who do this get approved. Patients who don’t spend three months waiting to start over.
Vein Health Clinics self-pay prices
These are our published self-pay rates. They apply if you’re paying out of pocket — because you’re uninsured, because you haven’t met your deductible, or because the treatment is cosmetic and won’t be covered.
| Service | Self-pay rate |
| Office visit | $150 |
| Ultrasound | $200 |
| Office visit + ultrasound (together) | $350 |
| Endovenous ablation | $1,000 per ablation |
| Varithena® | $1,000 per treatment |
| Ultrasound-guided sclerotherapy | $500 |
| Micro-phlebectomy | $500 |
| Sclerotherapy (spider veins) | $250 per session, or $1,000 for six sessions |
| Package: 4 or more ablations, including phlebectomy, ultrasound-guided sclerotherapy, sclerotherapy, ultrasound and follow-up as needed | $5,000 |
| Compression stockings — knee high / thigh high / pantyhose | $30 / $40 / $50 |
There is a 10% discount if you pay in full before your visit. Payment plans may be available. Contact our office for current financing options.
For context: published national self-pay ranges for the same procedures typically run $1,900–$2,700 for radiofrequency or laser ablation and $1,500–$2,500 for Varithena, and Medicare’s 2025 national office-based rate for a single-vein Varithena treatment is $1,183.⁴ Our rates sit at or below the low end of those ranges.
“How much does Varithena cost with insurance?”
This is the single most common cost question we see, so here is the honest answer.
If your Varithena treatment meets the medical-necessity criteria above — symptomatic, refluxing truncal vein, conservative therapy documented — it is billed to your insurance as a medical procedure, and what you pay is not the price of the procedure. It’s your plan’s deductible, coinsurance and out-of-pocket maximum. Two patients having the identical procedure on the same day can owe $0 and $2,400 respectively, purely because of where they are in their plan year.
That means the only number that matters to you personally is the one your own plan produces. Call us with your insurance card and we will verify your benefits before you commit to anything.
If it does not meet the criteria, our self-pay Varithena rate is $1,000 per treatment.
What actually changes the total
Four things move the final number more than the choice of procedure:
- One leg or two. Bilateral disease roughly doubles the treatment count. Most insurers require the legs to be treated on separate dates.
- How many veins. A single great saphenous vein is one ablation. Reflux in the great saphenous plus an accessory vein plus bulging tributaries needing phlebectomy is three separate line items — which is exactly why our multi-procedure package exists.
- Whether tributaries are treated at the same time. The 2022 SVS/AVF/AVLS guidelines address treating varicose tributaries with phlebectomy or foam either at the same session as the truncal ablation or in a staged fashion.³ Combining sessions can reduce total visits.
- The cosmetic finish. Once the medical problem is fixed, remaining surface spider veins are a separate, self-pay conversation. Nobody’s insurance covers that stage.
If you have no insurance
You have three real options, and none of them is “wait and see”:
- Self-pay at published rates, with the 10% prepayment discount.
- Financing through HFA Payment plans may be available. Contact our office for current financing options.
- Start with the $350 visit-plus-ultrasound. This is the step we’d push hardest. For $350 you find out whether you have true vein reflux or a cosmetic issue — and that single answer determines everything else, including whether an insurance claim is even possible.
Waiting is the expensive option. Untreated venous reflux is progressive; it can advance to skin changes and venous ulcers, which are far more costly and difficult to treat than the vein problem that caused them.
When leg symptoms are not a cost question at all
Go to an emergency room or call 911 rather than pricing out an elective procedure if you have:
- Sudden swelling, pain, warmth or redness in one leg — this can be a deep vein thrombosis (blood clot).
- Chest pain or sudden shortness of breath, especially with leg swelling — this can be a pulmonary embolism and is a medical emergency.
- Bleeding from a varicose vein. Lie down, elevate the leg above your heart, and apply firm direct pressure. If it does not stop, seek emergency care.
- An open sore on the ankle or lower leg that is not healing.
These are urgent medical situations, not elective ones.
FAQs
Is varicose vein treatment covered by insurance? Usually yes, if the veins cause medical symptoms and an ultrasound documents reflux, and if you’ve completed and documented a trial of conservative therapy. Purely cosmetic treatment is not covered.
Is spider vein treatment covered by insurance? Almost never. Medicare’s coverage policy specifically excludes treatment of telangiectasias as cosmetic,² and most commercial plans follow suit. Our self-pay sclerotherapy rate is $250 per session, or $1,000 for six sessions.
How much does vein treatment cost without insurance? At Vein Health Clinics, $150 for an office visit, $350 for a visit with ultrasound, and $1,000 per ablation or Varithena treatment, with a 10% discount for prepayment. [VERIFY item 1.]
Why does my insurer want me to wear compression stockings first? Because a documented trial of conservative therapy is a standard prerequisite for authorisation. It is a documentation requirement as much as a clinical one — so start it early and keep a record of the dates.
Does insurance cover the ultrasound? The diagnostic duplex ultrasound is generally billed to insurance when you have leg symptoms, because it’s a diagnostic test. Our self-pay rate is $200 on its own, or $350 bundled with the office visit. [Dr. Nwobi/billing — confirm.]
Will my varicose veins come back after treatment? Treated veins are permanently closed, but venous disease is a long-term condition and new veins can become varicose over time. Anyone promising a permanent one-and-done cure is overselling it.
Do you take Medicaid? The clinic needs to verify insurance coverage.
Find out where you stand
The $350 visit-and-ultrasound answers the only question that matters: do you have treatable vein reflux, and can it be billed to your insurance? Dr. Obinna Nwobi, MD, a board-certified vascular surgeon, sees patients at all five of our Florida locations.
| Location | Address | Phone |
| Winter Haven | 1121 1st St S, Winter Haven, FL 33880 | 877-817-8346 [phone verification pending] |
| Oviedo | 1000 Executive Dr, Suite 8, Oviedo, FL 32765 | 877-817-8346 |
| Winter Garden | 301 SW Crown Point Rd, Suite 140, Winter Garden, FL 34787 | 877-817-8346 [phone verification pending] |
| Port St. Lucie | 1801 SE Hillmoor Dr, Suite C-208, Port St. Lucie, FL 34952 | 772-261-5116 |
| Ocala | 1830 SE 18th Ave, Suite 3, Ocala, FL 34471 | 352-690-6000 |
Request an appointment → · Bring your insurance card and we’ll verify your benefits before you commit to anything.
Citations
- Centers for Medicare & Medicaid Services. Local Coverage Determination L38720, Treatment of Chronic Venous Insufficiency of the Lower Extremities. First Coast Service Options, Inc. (Jurisdiction N — Florida). Defines varicose veins as veins ≥3 mm in diameter with reflux >500 ms in an upright position. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38720
- Centers for Medicare & Medicaid Services. Local Coverage Determination, Treatment of Varicose Veins of the Lower Extremities. States that treatment of telangiectasias is not covered and that sclerotherapy for cosmetic purposes is not medically necessary. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=34209
- Gloviczki P, et al. The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part I. J Vasc Surg Venous Lymphat Disord. 2023;11(2):231–261. Guideline 2.1.1 recommends superficial venous intervention over long-term compression stockings (grade 1, evidence B). PMID 36326210.
- Boston Scientific / Varithena. 2025 Coding and Reimbursement Guide. Medicare non-facility total payment: CPT 36465 (single truncal vein) $1,183; CPT 36466 (multiple truncal veins, same leg) $1,242. https://www.varithena.com/content/dam/varithena/hcp/pdf/varithena-coding-reimbursement-guide.pdf
Vein Health Clinics, /patient-information/, self-pay rate schedule as published on the live site (page last modified 2026-04-28).
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