CMS Price Transparency Data

X-ray, shoulder

Facility: City of Hope National Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $403
Cash Discount Price: $503
vs. Medicare Baseline: 4.53x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at City of Hope National Medical Center is $403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $503. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.53x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$503

Average discount available for prompt cash payment at this facility.

Insurance Median

$403

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: $503 (566%)

Insurance Median: $403 (453%)

Cash: $503 (566% of Medicare)

Ins. Median: $403 (453% 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 453% of the Medicare baseline (a markup of 353%). 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	$18 - $585	20%
Cal Optima	$25 - $36	28%
Heritage Provider Network	$32 - $422	36%
Inland Empire	$37 - $483	42%
Prime Healthcare Keenan	$52 - $579	58%
Blue Cross Blue Shield	$163 - $422	183%
UnitedHealthcare	$225 - $380	253%
Blue Shield	$238 - $719	268%
Blue Shield Covca	$245 - $367	276%
Blue Shield Promise	$282 - $422	317%
Cencal	$322 - $483	362%
La Care Health	$322 - $483	362%
Kaiser	$362 - $543	407%
Aetna	$402 - $604	452%
Gold Coast	$402 - $604	452%
Molina	$402 - $785	452%
Cigna	$425	478%
Facey	$443 - $664	498%
Healthcare Partners	$467 - $700	525%
St. Joseph Heritage	$483 - $724	543%
Primecare Medical Network	$523 - $785	588%
First Health	$620 - $929	697%
Phcs Multiplan	$724 - $1,086	814%

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 $503.
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 City of Hope National 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.