CMS Price Transparency Data

X-ray, hand

Facility: Nemours Childrens Hospital, Florida

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $274
Cash Discount Price: $672
vs. Medicare Baseline: 3.08x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Nemours Childrens Hospital, Florida is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $672. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.08x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$672

Average discount available for prompt cash payment at this facility.

Insurance Median

$274

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: $672 (756%)

Insurance Median: $274 (308%)

Cash: $672 (756% of Medicare)

Ins. Median: $274 (308% 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 308% of the Medicare baseline (a markup of 208%). 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
Truli	$66 - $269	74%
Florida Blue	$73 - $410	82%
Tricare	$88	99%
Aetna	$120 - $296	135%
Cigna	$161 - $271	181%
Avmed	$208	234%
UnitedHealthcare	$257	289%
Employers Health Network Fl	$269	303%
Evolutions Healthcare	$302	340%
Integra Administrative Group	$403	453%
Global Medical Management	$437	492%
Prime Health Services	$437	492%
Star Healthcare Network	$437	492%
Velocity	$504	567%
First Health Network	$524	589%
Pnoa	$538	605%
Seminole Tribe Of Fl	$538	605%
Private Healthcare Systems	$618	695%

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 $672.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Nemours Childrens Hospital, Florida is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
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.