CMS Price Transparency Data

X-ray, shoulder

Facility: Hospital Pavia Arecibo

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $14
Cash Discount Price: $49
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Hospital Pavia Arecibo is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.16x the Medicare baseline. Located in Carretera 129 Km.1 Avenida San Luis, Arecibo, PR.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $49 (55%)

Insurance Median: $14 (16%)

Cash: $49 (55% of Medicare)

Ins. Median: $14 (16% 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
Acaa	$8	9%
First Medical	$9 - $14	10%
Fondo Del Seguro Estado	$9	10%
Medicare (plans)	$9	10%
Mso	$9 - $14	10%
Plan Auxilio Mutuo	$9	10%
Plan De Salud Menonita	$9 - $11	10%
Triple S	$9 - $20	10%
Cigna	$11	12%
Comerciales	$13	15%
Hospicio	$13	15%
Mc	$13	15%
Prossam	$13	15%
Bl	$14	16%
Mapfre	$14	16%
Mcs	$14 - $21	16%
Privado	$14	16%
Auxilio Platino	$16	18%
Humana	$16 - $21	18%
Ch	$21	24%
Tricare	$21	24%
Va	$21	24%
Aarp	$23	26%

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 $49.
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 Hospital Pavia Arecibo 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.