CMS Price Transparency Data

X-ray, shoulder

Facility: Hospital Perea

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $13
Cash Discount Price: $40
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Hospital Perea is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.15x the Medicare baseline. Located in 15 Dr Basora Street, Mayaguez, PR.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $40 (45%)

Insurance Median: $13 (15%)

Cash: $40 (45% of Medicare)

Ins. Median: $13 (15% 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	$8 - $14	9%
Va	$10	11%
Cigna	$11	12%
Mso	$11 - $16	12%
Plan De Salud Menonita	$11 - $14	12%
Humana	$12 - $18	13%
Mapfre	$12	13%
Mc	$12	13%
Mcs	$12 - $16	13%
Privado	$12	13%
Triple S	$12 - $20	13%
Ch	$13	15%
Prossam	$13	15%
Bl	$14	16%
Comerciales	$15	17%
Medicare (plans)	$17	19%
Tricare	$17	19%
Bella Vista	$18	20%
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 $40.
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 Perea 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.