CMS Price Transparency Data

X-ray, shoulder

Facility: AHMC Seton Medical Center

Billing Code: 73030 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$125

about 1.4× the $89 Medicare rate · typically $86–$133

modeled estimate · not a bill or quote

What this hospital charges insurers

$124

About the fair price

about $1 under the fair price · 1.4× Medicare

Medicare pays $89 Fair price $125 This hospital $124 Cash price $682 Hospital's list price $853

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $19 Priciest $124

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a X-ray, shoulder is about $125 (about 1.4× the $89 Medicare rate). AHMC Seton Medical Center charges insurers about $124, or about $682 in cash — about the fair price. Located in Daly City, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$114 - $132	128%
Blue Cross Blue Shieldmajor	$8 - $648	9%
Aetnamajor	$112 - $549	126%
Cignamajor	$348	391%
Humanamajor	$112 - $124	126%
Kaiser Permanentemajor	$37 - $699	42%
Health Net	$112 - $654	126%
+ 28 smaller / regional plans	$32 - $853

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 8 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 682), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 73030.

Insurance Before you use insurance

Call your insurance company to confirm AHMC Seton Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 73030.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at AHMC Seton Medical Center

Compare: X-ray, shoulder at other CA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.