CMS Price Transparency Data

X-ray, hand

Facility: Grossmont Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $383
Cash Discount Price: $509
vs. Medicare Baseline: 4.31x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Grossmont Hospital is $383. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $509. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.31x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$509

Average discount available for prompt cash payment at this facility.

Insurance Median

$383

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $509 (572%)

Insurance Median: $383 (431%)

Cash: $509 (572% of Medicare)

Ins. Median: $383 (431% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 431% of the Medicare baseline (a markup of 331%). 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
Health Net	$102 - $508	115%
Epic Americas	$190	214%
Cigna	$201 - $383	226%
Humana	$201	226%
Medi-Cal	$201	226%
Blue Cross Blue Shield	$207 - $431	233%
California Health And Wellness	$285	321%
Aetna	$325 - $626	366%
San Diego Pace	$325	366%
Medicare (plans)	$373	420%
UnitedHealthcare	$378 - $475	425%
Indian Health Council	$383	431%
Kaiser	$383	431%
Molina	$424 - $508	477%
Blue Shield	$427	480%
Managed Health Network	$431	485%
Community Health Group	$454	511%
Interplan	$468	526%

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 $509.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
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.