CMS Price Transparency Data

X-ray, shoulder

Facility: Sarasota Memorial Hospital - Venice

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $610
Cash Discount Price: $441
vs. Medicare Baseline: 6.86x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Sarasota Memorial Hospital - Venice is $610. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.86x the Medicare baseline. Located in 2600 Laurel Road East, North Venice, FL.

Cash / Self-Pay

$441

Average discount available for prompt cash payment at this facility.

Insurance Median

$610

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: $441 (496%)

Insurance Median: $610 (686%)

Cash: $441 (496% of Medicare)

Ins. Median: $610 (686% 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 686% of the Medicare baseline (a markup of 586%). 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
Simply Healthcare	$36 - $37	40%
Sunshine State	$37	42%
Molina	$38	43%
Amerihealth Caritas	$39	44%
Community Care Plan	$39	44%
Florida Community Care	$39 - $97	44%
Blue Cross Blue Shield	$88	99%
Aetna	$91 - $1,176	102%
UnitedHealthcare	$91 - $1,104	102%
Simply Freedom Optimum	$93	105%
Wellcare	$93	105%
Ambetter / Centene	$239	269%
Careworks	$381 - $484	429%
Enlyte	$381 - $484	429%
Avmed	$537 - $1,073	604%
Usa Managed Care	$588 - $1,176	661%
First Health	$610 - $1,220	686%

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 $441.
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 Sarasota Memorial Hospital - Venice 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.