CMS Price Transparency Data

X-ray, shoulder

Facility: Community Memorial Hospital - Ventura

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $112
Cash Discount Price: $152
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Community Memorial Hospital - Ventura is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.26x the Medicare baseline. Located in 147 North Brent Street, Ventura, CA.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $152 (171%)

Insurance Median: $112 (126%)

Cash: $152 (171% of Medicare)

Ins. Median: $112 (126% 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
Seaview	$31	35%
Medi-Cal	$37	42%
Non Contracted	$37 - $112	42%
Valley Care	$50 - $63	56%
Medicaid / KanCare	$54 - $89	61%
Gold Coast Health Plan	$56 - $89	63%
Ventura County Health Care Plan	$63	71%
Kaiser Commercial	$103	116%
Tricare	$106	119%
Aetna	$112 - $185	126%
Blue Cross Blue Shield	$112 - $340	126%
California Workers Compensation	$112	126%
Medicare (plans)	$112 - $114	126%
Wellcare Of California	$112	126%
Blue Shield Epn	$113	127%
Alignment Health Plan	$114	128%
Humana	$114	128%
Scan Health Plan	$114	128%
UnitedHealthcare	$114 - $195	128%
Blue Shield Commercial	$127	143%
Health Net Commercial	$141	159%
Multiplan	$152	171%
Cigna	$227	255%

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 $152.
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 Community Memorial Hospital - Ventura 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.