CMS Price Transparency Data

X-ray, shoulder

Facility: Adventist Health Delano

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $192
Cash Discount Price: $69
vs. Medicare Baseline: 2.16x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Adventist Health Delano is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.16x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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: $69 (78%)

Insurance Median: $192 (216%)

Cash: $69 (78% of Medicare)

Ins. Median: $192 (216% 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 216% of the Medicare baseline (a markup of 116%). 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 Cross Blue Shield	$14 - $342	16%
Dignty Hlth Mcal Op Only	$37	42%
Kaiser Medi-Cal Ip/Op Only	$37	42%
Medi-Cal	$37	42%
Universal Care Mcal	$37	42%
Healthnet Medi-Cal	$44	49%
Kern Health System Mcal	$48	54%
Blue Shield Epn - All Other Plans	$60 - $90	67%
Bakersfield Fam Med Grp-All Plans	$112	126%
Healthnet Mcr Adv	$112	126%
Kern Mcr Adv Dual Dnsp-All Other Plans	$112	126%
Medicare (plans)	$112 - $179	126%
Tricare	$112	126%
UnitedHealthcare	$112 - $296	126%
Universal Care Mcr- All Other Plans	$112	126%
Coventry- All Plans	$164 - $247	184%
Blue Shield Non-Epn	$178 - $267	200%
Healthnet- All Other Plans	$184 - $277	207%
County Of Kern Network - All Plans	$192 - $288	216%
Gem Care- All Plans	$192 - $288	216%
Kaiser Comm Ip/Op Only- All Other Plans	$193	217%
Ah Employee Health Plan - All Plans	$201	226%
Aetna	$202 - $303	227%
Foundation For Medical Care Of Kern County - All P	$206 - $308	232%
Cigna	$219 - $329	246%
Western Growers - All Plans	$222 - $333	250%
Centivo - All Plans	$252	283%

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 $69.
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 Delano 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.