CMS Price Transparency Data

X-ray, foot

Facility: Central Florida Lake Monroe Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $1,397
Cash Discount Price: $3,881
vs. Medicare Baseline: 15.71x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Central Florida Lake Monroe Hospital is $1,397. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,881. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 15.71x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$3,881

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,397

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: $3,881 (4365%)

Insurance Median: $1,397 (1571%)

Cash: $3,881 (4365% of Medicare)

Ins. Median: $1,397 (1571% 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 1571% of the Medicare baseline (a markup of 1471%). 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 - $2,095	205%
Freedom Health	$224 - $335	252%
Optimum	$224 - $335	252%
Corvel Corporation	$414	466%
Prime Health	$422	475%
Careworks (Rockport Community)	$435	489%
Simply	$478 - $717	538%
Molina Healthcare	$590 - $1,490	664%
Humana	$621 - $931	698%
Evolutions	$714 - $1,071	803%
Avmed	$745 - $2,328	838%
Sunshine State Health Plan	$792 - $1,187	891%
Aetna	$932 - $1,397	1048%
Florida Health Care Plan	$1,171 - $1,755	1317%
Plotkin Health	$1,552 - $2,328	1746%
Prime Health Sheriff	$1,552 - $2,328	1746%
Multiplan	$2,329 - $3,958	2620%
Three Rivers Provider Network	$2,329 - $3,492	2620%
Ppo Next	$2,639 - $3,958	2968%
Novanet	$2,794 - $4,190	3143%

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 $3,881.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73630.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Central Florida Lake Monroe Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73630.
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.