CMS Price Transparency Data

X-ray, shoulder

Facility: St Lucie Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $573
Cash Discount Price: $2,205
vs. Medicare Baseline: 6.44x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at St Lucie Medical Center is $573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,205. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.44x the Medicare baseline. Located in 1800 Se Tiffany Ave, Port Saint Lucie, FL.

Cash / Self-Pay

$2,205

Average discount available for prompt cash payment at this facility.

Insurance Median

$573

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: $2,205 (2480%)

Insurance Median: $573 (644%)

Cash: $2,205 (2480% of Medicare)

Ins. Median: $573 (644% 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 644% of the Medicare baseline (a markup of 544%). 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 - $992	205%
Freedom Health	$190 - $353	214%
Optimum	$190	214%
Avmed	$287 - $1,102	323%
Simply Healthcare Plans	$287	323%
Molina	$419 - $595	471%
Corvel Corporation	$455	512%
Careworks (Rockport)	$465	523%
Prime Health	$465	523%
Health Sun Health Plan	$470	529%
Sunshine State Health Plan	$562	632%
Aetna	$662	745%
Humana	$816 - $882	918%
United Ppo	$970	1091%
Plotkin Health	$1,102	1239%
Prime Health Sherriff	$1,102	1239%
Multiplan	$1,654 - $1,874	1860%

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 $2,205.
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 St Lucie Medical Center 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.