CMS Price Transparency Data

X-ray, shoulder

Facility: HCA Florida Kendall Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $968
Cash Discount Price: $3,723
vs. Medicare Baseline: 10.89x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at HCA Florida Kendall Hospital is $968. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,723. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 10.89x the Medicare baseline. Located in 11750 Bird Rd, Miami, FL.

Cash / Self-Pay

$3,723

Average discount available for prompt cash payment at this facility.

Insurance Median

$968

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: $3,723 (4187%)

Insurance Median: $968 (1089%)

Cash: $3,723 (4187% of Medicare)

Ins. Median: $968 (1089% 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 1089% of the Medicare baseline (a markup of 989%). 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 - $1,675	205%
Freedom Health	$320 - $596	360%
Optimum	$320	360%
Avmed	$447 - $1,862	503%
Corvel Corporation	$476	535%
Simply Healthcare Plans	$484	544%
Careworks (Rockport)	$486	547%
Prime Health	$486	547%
Molina	$707 - $1,005	795%
Humana	$782 - $1,266	880%
Health Sun Health Plan	$793	892%
Aids Healthcare	$819 - $4,468	921%
Mmm Of Fl (Health Advantage Plan)	$856	963%
United Ppo	$882	992%
Sunshine State Health Plan	$968	1089%
Aetna	$1,117	1256%
Plotkin Health	$1,862	2094%
Prime Health Sherriff	$1,862	2094%
Medica Healthcare	$2,159	2428%
Multiplan	$2,792 - $3,165	3140%
Evernorth Bh	$2,978	3349%

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 $3,723.
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 Kendall 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.