CMS Price Transparency Data

X-ray, shoulder

Facility: Palm Bay Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $251
Cash Discount Price: $105
vs. Medicare Baseline: 2.82x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Palm Bay Hospital is $251. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.82x the Medicare baseline. Located in 1425 Malabar Rd, Ne, Palm Bay, FL.

Cash / Self-Pay

$105

Average discount available for prompt cash payment at this facility.

Insurance Median

$251

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: $105 (118%)

Insurance Median: $251 (282%)

Cash: $105 (118% of Medicare)

Ins. Median: $251 (282% 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 282% of the Medicare baseline (a markup of 182%). 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
Health First Health Plan	$14 - $125	16%
Humana	$36 - $418	40%
Molina Healthcare	$36 - $468	40%
Aetna	$37 - $460	42%
Amerigroup	$37 - $418	42%
Sunshine Health Plan	$37 - $439	42%
UnitedHealthcare	$37 - $619	42%
Corizon Health	$91	102%
Florida Healthcare Plans	$132	148%
Cigna	$161 - $172	181%
Disney Cruise Line	$251	282%
Prime Heath Services, Inc.	$314	353%
Multiplan	$334	376%
Florida Blue	$493 - $525	554%

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 $105.
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 Palm Bay 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.