CMS Price Transparency Data

X-ray, hand

Facility: Central Florida Lake Monroe Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $1,304
Cash Discount Price: $3,622
vs. Medicare Baseline: 14.67x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Central Florida Lake Monroe Hospital is $1,304. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,622. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 14.67x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$3,622

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,304

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: $3,622 (4074%)

Insurance Median: $1,304 (1467%)

Cash: $3,622 (4074% of Medicare)

Ins. Median: $1,304 (1467% 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 1467% of the Medicare baseline (a markup of 1367%). 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 - $1,955	205%
Freedom Health	$209 - $313	235%
Optimum	$209 - $313	235%
Corvel Corporation	$406	457%
Prime Health	$414	466%
Careworks (Rockport Community)	$427	480%
Simply	$446 - $669	502%
Molina Healthcare	$551 - $1,391	620%
Humana	$580 - $869	652%
Evolutions	$667 - $999	750%
Avmed	$696 - $2,173	783%
Sunshine State Health Plan	$739 - $1,108	831%
Aetna	$869 - $1,304	977%
Florida Health Care Plan	$1,093 - $1,638	1229%
Plotkin Health	$1,449 - $2,173	1630%
Prime Health Sheriff	$1,449 - $2,173	1630%
Multiplan	$2,174 - $3,694	2445%
Three Rivers Provider Network	$2,174 - $3,259	2445%
Ppo Next	$2,464 - $3,694	2771%
Novanet	$2,608 - $3,911	2933%

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 $3,622.
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 Central Florida Lake Monroe 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.