CMS Price Transparency Data

X-ray, shoulder

Facility: HCA Florida Highlands Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $891
Cash Discount Price: $3,446
vs. Medicare Baseline: 10.02x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at HCA Florida Highlands Hospital is $891. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,446. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 10.02x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.

Cash / Self-Pay

$3,446

Average discount available for prompt cash payment at this facility.

Insurance Median

$891

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: $3,446 (3876%)

Insurance Median: $891 (1002%)

Cash: $3,446 (3876% of Medicare)

Ins. Median: $891 (1002% 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 1002% of the Medicare baseline (a markup of 902%). 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
United	$182 - $2,088	205%
Freedom Health	$194 - $399	218%
Avmed	$293 - $2,320	330%
Prime Health	$409	460%
Molina	$428 - $882	481%
Aetna	$676 - $1,392	760%
Office Of Sheiff Highland Co	$788 - $1,624	886%
Humana	$833 - $1,856	937%
United Ppo	$991 - $2,042	1115%

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 $3,446.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73030.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Highlands Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73030.
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.