CMS Price Transparency Data

X-ray, shoulder

Facility: El Centro Regional Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $397
Cash Discount Price: $496
vs. Medicare Baseline: 4.47x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at El Centro Regional Medical Center is $397. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $496. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.47x the Medicare baseline. Located in 1415 Ross Avenue, El Centro, CA.

Cash / Self-Pay

$496

Average discount available for prompt cash payment at this facility.

Insurance Median

$397

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: $496 (558%)

Insurance Median: $397 (447%)

Cash: $496 (558% of Medicare)

Ins. Median: $397 (447% 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 447% of the Medicare baseline (a markup of 347%). 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
Blue Shield-All Plans	$56	63%
Blue Cross Blue Shield	$112 - $708	126%
Brand New Day Comm - All Other Plans	$112	126%
Brand New Day Mcr	$112	126%
Healthnet Mcr Adv	$112	126%
Molina Mcr Adv	$112	126%
Scp Managed Care - All Plans	$112	126%
Tricare	$112	126%
UnitedHealthcare	$112 - $355	126%
Easy Choice Mcr Adv-All Plans	$123	138%
Healthnet Hmo	$140	157%
Cdcr Correctional-All Plans	$145	163%
Aetna	$312	351%
Pacificare-All Plans	$439	494%
Mulitplan Primary - All Other Plans	$481	541%
Cigna	$531	597%
Multiplan Comp	$566	637%
Trident - All Plans	$602	677%
Healthnet Comm-All Other Plans	$637	716%
Humana	$658	740%
Ahccs/Medi-Cal Misc - All Plans	$708	796%
Brand New Day Mcal	$708	796%
Medi-Cal	$708	796%
Molina Exchange - All Other Plans	$708	796%
Ambetter / Centene	$729	820%
Molina Mcal	$779	876%

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 $496.
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 El Centro Regional 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.