CMS Price Transparency Data

X-ray, shoulder

Facility: Banner Payson Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $112
Cash Discount Price: $131
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Banner Payson Medical Center is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.26x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $131 (147%)

Insurance Median: $112 (126%)

Cash: $131 (147% of Medicare)

Ins. Median: $112 (126% 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
Arizona Physicians Ipa	$59 - $102	66%
Banner University Health Plan	$59 - $102	66%
Health Choice Arizona, Inc.	$59 - $145	66%
Health Net	$59 - $150	66%
Mercy Care	$59 - $102	66%
Aetna	$101 - $164	114%
Banner Health	$102	115%
Blue Cross Blue Shield	$102 - $143	115%
Care 1St	$102	115%
Cigna	$102 - $197	115%
Gila River Health Care Corporation	$102	115%
Kaiser Foundation Health Plan	$102	115%
Triwest Healthcare Alliance Corp - Va Ccn	$102	115%
UnitedHealthcare	$102 - $166	115%
Upmc Health Plan	$102	115%
Wellpoint	$102	115%
Carelon	$107	120%
Humana	$108	121%
Arizona Priority Care	$112	126%
Devoted Health Services	$112	126%
Gold Kidney Health Plan	$112	126%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$112	126%
Plotkin Health	$112	126%
Oscar Health Plan	$168	189%
Quiktrip Corporation	$174	196%
Arizona Medical Network	$223	251%
Provider Network Of America	$223	251%

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 $131.
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 Banner Payson Medical Center 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.