CMS Price Transparency Data

X-ray, shoulder

Facility: Marion Communtiy Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $1,133
Cash Discount Price: $2,739
vs. Medicare Baseline: 12.74x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Marion Communtiy Hospital is $1,133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,739. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 12.74x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.

Cash / Self-Pay

$2,739

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,133

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: $2,739 (3081%)

Insurance Median: $1,133 (1274%)

Cash: $2,739 (3081% of Medicare)

Ins. Median: $1,133 (1274% 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 1274% of the Medicare baseline (a markup of 1174%). 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 - $2,888	205%
Avmed	$288 - $1,797	324%
Simply	$370 - $988	416%
Corvel Corporation	$417	469%
Prime Health	$425	478%
Careworks (Rockport Community)	$439	494%
Marion County Schools	$439	494%
Molina Healthcare	$456 - $2,054	513%
Humana	$480 - $1,284	540%
Evolutions	$553 - $1,476	622%
Evolutions Healthcare	$553 - $1,476	622%
Sunshine State Health Plan	$613 - $1,636	689%
Aetna	$721 - $1,925	811%
Plotkin Health	$1,201 - $3,209	1351%
Prime Health Sheriff	$1,201 - $3,209	1351%
Multiplan	$1,874 - $5,006	2108%
Ppo Next	$2,042 - $5,455	2297%
Novanet	$2,162 - $5,776	2432%

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 $2,739.
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 Marion Communtiy 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.