CMS Price Transparency Data
X-ray, shoulder
Facility: Mercy Hospital Waldron
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $210
- Cash Discount Price: $395
- vs. Medicare Baseline: 2.36x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy Hospital Waldron is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $395. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.36x the Medicare baseline. Located in 1341 West Sixth Street, Waldron, AR.
Cash / Self-Pay
$395
Average discount available for prompt cash payment at this facility.
Insurance Median
$210
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: $395 (444%)
Insurance Median: $210 (236%)
Cash: $395 (444% of Medicare)
Ins. Median: $210 (236% 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 236% of the Medicare baseline (a markup of 136%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 |
|---|---|---|
| Medicaid / KanCare | $20 - $299 | 22% |
| Summit Community Care Contracted [320368] | $20 | 22% |
| Aetna | $30 - $498 | 34% |
| Humana | $30 - $651 | 34% |
| Novasys Contracted [320285] | $33 - $299 | 37% |
| Arkansas Total Care Contracted [320039] | $45 | 51% |
| Blue Cross Blue Shield | $105 - $210 | 118% |
| Usable Contracted [320409] | $105 | 118% |
| Tricare | $121 - $207 | 136% |
| American Health Advantage Of Mo Mcr [20264] | $123 - $210 | 138% |
| Cherokee Nation Health Serv Contracted [320066] | $123 - $210 | 138% |
| Cross Timbers Hospice [20098] | $123 - $210 | 138% |
| Dept Of Veteran Affairs Contracted [320106] | $123 - $210 | 138% |
| Elara Caring Aspire Hospice Contracted [320433] | $123 - $210 | 138% |
| Elara Caring Aspire Hospice [20433] | $123 - $210 | 138% |
| Globalhealth Contracted [320145] | $123 - $210 | 138% |
| Halo Hcr Inc Hospice Contracted [320432] | $123 - $210 | 138% |
| Halo Hcr Inc Hospice [20432] | $123 - $210 | 138% |
| Independent Health [20197] | $123 - $210 | 138% |
| Indian Health Service Contracted [320198] | $123 - $210 | 138% |
| Indian Health Service [20198] | $123 - $210 | 138% |
| Jordan Valley Senior Care Pace [20515] | $123 - $210 | 138% |
| Kindful Hospice Contracted [320434] | $123 - $210 | 138% |
| Kindful Hospice [20434] | $123 - $210 | 138% |
| Medical Associates Health [20444] | $123 - $210 | 138% |
| Medicare (plans) | $123 - $221 | 138% |
| Mercy Hospice Okc [20252] | $123 - $210 | 138% |
| Pace Of The Ozarks [20518] | $123 - $210 | 138% |
| Provider Partners Health Plans Contracted [320450] | $123 - $210 | 138% |
| Qual Choice Contracted [320325] | $123 - $210 | 138% |
| Spina Bifida Hlthcare Benefit [20506] | $123 - $210 | 138% |
| UnitedHealthcare | $123 - $210 | 138% |
| Valir Pace [20503] | $123 - $210 | 138% |
| Cigna | $129 - $651 | 145% |
| Qual Choice Contracted [320324] | $136 | 153% |
| Ambetter / Centene | $175 - $299 | 197% |
| Home State Health Plan Contracted [320187] | $175 - $299 | 197% |
| United Medical Resources Contracted [320454] | $180 | 202% |
| Mercy Interfacility [20513] | $200 - $341 | 225% |
| Auxiant Contracted [320462] | $269 - $689 | 303% |
| Mercy Benefit Admin Contracted [320251] | $269 - $689 | 303% |
| Workers Comp [20426] | $292 - $498 | 328% |
| 90 Degree Benefits Contracted [320436] | $382 - $651 | 430% |
| Aither Health Contracted [320449] | $382 - $651 | 430% |
| Ebms Contracted [320493] | $382 - $651 | 430% |
| Edison Health Solutions Contracted [320502] | $382 - $651 | 430% |
| Healthlink Contracted [320179] | $382 - $689 | 430% |
| Imagine 360 Contracted [320494] | $382 - $651 | 430% |
| Multiplan Contracted [320270] | $382 - $651 | 430% |
| Multiplan [20270] | $382 - $651 | 430% |
| Municipal Health Plan Contracted [320271] | $382 - $651 | 430% |
| Reflect Health Contracted [320492] | $382 - $651 | 430% |
| Show-Me Health Administrators Contracted [320483] | $382 - $651 | 430% |
| Federal Medical Center Contracted [320127] | $404 - $689 | 454% |
| Healthscope Contracted [320182] | $404 - $689 | 454% |
| Insurance System Inc Contracted [320465] | $404 - $689 | 454% |
| Personify Health Contracted [320051] | $404 - $689 | 454% |
| Point C Contracted [320238] | $404 - $689 | 454% |
| Preferred Health Plan Contracted [320522] | $404 - $689 | 454% |
| Tri State Healthcare Coalition Contracted [320379] | $404 - $689 | 454% |