CMS Price Transparency Data

X-ray, hand

Facility: Promedica Monroe Regional Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $88
Cash Discount Price: $219
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Promedica Monroe Regional Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.99x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.

Cash / Self-Pay

$219

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $219 (246%)

Insurance Median: $88 (99%)

Cash: $219 (246% of Medicare)

Ins. Median: $88 (99% 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.

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
Paramount Healthcare Inc	$34 - $256	38%
Aetna	$35 - $237	39%
Blue Cross Blue Shield	$35 - $189	39%
Health Alliance Plan	$35 - $276	39%
Priority Health	$35 - $185	39%
Humana	$36 - $89	40%
Amerihealth	$39	44%
Meridian	$48	54%
Molina Healthcare Of Michigan	$51	57%
UnitedHealthcare	$52 - $274	58%
Veterans Affairs	$88	99%
Frontpath	$195	219%
Encore Health Network	$236	265%
Health Ohio Network, Llc	$236	265%
Cofinity	$240	270%
Multiplan	$303	341%

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 $219.
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 Promedica Monroe Regional Hospital 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.