CMS Price Transparency Data

X-ray, shoulder

Facility: Lower Keys Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $569
  • Cash Discount Price: $420
  • vs. Medicare Baseline: 6.40x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Lower Keys Medical Center is $569. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $420. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.40x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$420

Average discount available for prompt cash payment at this facility.

Insurance Median
$569

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: $420 (472%)
Insurance Median: $569 (640%)
Cash: $420 (472% of Medicare)
Ins. Median: $569 (640% 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 640% of the Medicare baseline (a markup of 540%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Prime Health Work Comp Fl $45 51%
Fl Work Comp $46 52%
Heritage Summit Work Comp Fl $46 52%
Florida Childrens Medical Services $54 - $81 61%
Medicaid / KanCare $54 - $90 61%
South Florida Community Care Network $54 - $81 61%
Humana $56 - $96 63%
Amerigroup $60 - $90 67%
Positive Healthcare $60 - $90 67%
Simply Healthcare $60 - $569 67%
Wellcare $60 - $90 67%
Wellcare Healthease $60 - $90 67%
Molina $61 - $92 69%
UnitedHealthcare $62 - $1,411 70%
Prestige Health Choice $63 - $94 71%
Magellan $65 - $98 73%
Veterans Eval Services $84 - $167 94%
Tricare $92 103%
Blue Cross Blue Shield $96 - $1,683 108%
Medicare (plans) $96 108%
Ultimate Health $96 108%
Node Champva $97 109%
Node Non Par Hospice Agree $97 109%
Node United Behavioral Va Ccn $97 109%
Node Va $97 109%
Correct Care Solutions $107 120%
Node Us Dept Of Labor $122 137%
State Auto Insurance Fl $195 219%
Self Pay $266 - $642 299%
Cigna $581 - $1,083 653%
Aetna $687 - $1,281 773%
Monroe County $739 - $1,377 831%
Evolutions Healthcare Systems $788 - $1,744 886%
Keys Energy $788 - $1,468 886%
Prime Health Ppo $788 - $1,468 886%
Avmed Health Plan $837 - $1,560 941%
Direct Healthcare $985 - $1,835 1108%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals