CMS Price Transparency Data

X-ray, shoulder

Facility: Mercy Rehabilitation Hospital Northwest Arkansas

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $265
Cash Discount Price: $279
vs. Medicare Baseline: 2.98x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy Rehabilitation Hospital Northwest Arkansas is $265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $279. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.98x the Medicare baseline. Located in 4313 S Pleasant Crossing Blvd, Rogers, AR.

Cash / Self-Pay

$279

Average discount available for prompt cash payment at this facility.

Insurance Median

$265

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: $279 (314%)

Insurance Median: $265 (298%)

Cash: $279 (314% of Medicare)

Ins. Median: $265 (298% 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 298% of the Medicare baseline (a markup of 198%). 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
Phcs	$162 - $311	182%
Multiplan	$174 - $335	196%
Aetna	$205 - $394	231%
Ambetter / Centene	$205 - $394	231%
American Health Plan	$205 - $394	231%
Arkansas Total Care (Passe)	$205 - $394	231%
Blue Cross Blue Shield	$205 - $394	231%
Care Source (Passe)	$205 - $394	231%
Cigna	$205 - $394	231%
Devoted	$205 - $394	231%
Empower	$205 - $394	231%
Essence	$205 - $394	231%
Humana	$205 - $394	231%
Medicaid / KanCare	$205 - $394	231%
Medicare (plans)	$205 - $394	231%
Municipal League	$205 - $394	231%
Qualchoice	$205 - $394	231%
Summit (Passe)	$205 - $394	231%
UnitedHealthcare	$205 - $394	231%
Vaccn	$205 - $394	231%

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 $279.
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 Mercy Rehabilitation Hospital Northwest Arkansas 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.