CMS Price Transparency Data

X-ray, shoulder

Facility: Grossmont Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $425
Cash Discount Price: $565
vs. Medicare Baseline: 4.78x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Grossmont Hospital is $425. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $565. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.78x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$565

Average discount available for prompt cash payment at this facility.

Insurance Median

$425

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: $565 (635%)

Insurance Median: $425 (478%)

Cash: $565 (635% of Medicare)

Ins. Median: $425 (478% 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 478% of the Medicare baseline (a markup of 378%). 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
Health Net	$105 - $617	118%
Multiplan	$105 - $467	118%
Aetna	$224 - $617	252%
Blue Cross Blue Shield	$224 - $425	252%
Community Health Group	$224 - $505	252%
Molina	$256 - $602	288%
San Diego Pace	$296	333%
Cigna	$361 - $527	406%
County Medical Services	$361	406%
Medi-Cal	$414	466%
UnitedHealthcare	$414 - $520	466%
Kaiser	$425	478%
Humana	$459	516%
California Health And Wellness	$494	556%
Allianz Global Assistance	$500	562%
Epic Americas	$505	568%
Blue Shield	$565	635%

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 $565.
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 Grossmont Hospital 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.