CMS Price Transparency Data

X-ray, shoulder

Facility: Adventist Health Ukiah Valley

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $73
Cash Discount Price: $18
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Adventist Health Ukiah Valley is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.82x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $18 (20%)

Insurance Median: $73 (82%)

Cash: $18 (20% of Medicare)

Ins. Median: $73 (82% 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
Blue Shield Mcr Adv	$9 - $120	10%
Kaiser Mcr Adv	$9 - $120	10%
Tricare	$9 - $120	10%
Ah Employee Health Plan - All Plans	$10 - $216	11%
Cigna	$12 - $1,170	13%
UnitedHealthcare	$12 - $1,254	13%
Blue Shield Epn-All Other Plans	$13 - $572	15%
Healthnet-All Plans	$13 - $858	15%
Blue Shield Non-Epn	$14 - $579	16%
Western Growers-All Plans	$14 - $630	16%
Aetna	$19 - $144	21%
Mendocino Lcc District-All Plans	$23 - $975	26%
Kaiser Medi-Cal	$26 - $37	29%
Medi-Cal	$26 - $37	29%
Kaiser-All Other Plans	$29 - $1,200	33%
Three Rivers-All Plans	$32 - $1,350	36%
Foundation For Medical Care-All Plans	$44 - $1,125	49%
Networks By Design-All Plans	$47 - $1,200	53%
Phcs Multiplan-All Plans	$47 - $1,200	53%
Interplan-All Plans	$48 - $1,230	54%
Beech Street-All Plans	$50 - $1,275	56%
Choice Care-All Plans	$50 - $1,275	56%
Health Mgmt Network-All Plans	$50 - $1,275	56%
Blue Cross Blue Shield	$165 - $220	186%

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 $18.
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 Adventist Health Ukiah Valley 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.