CMS Price Transparency Data

X-ray, shoulder

Facility: Loma Linda University Children's Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $183
Cash Discount Price: $365
vs. Medicare Baseline: 2.06x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Loma Linda University Children's Hospital is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $365. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.06x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$365

Average discount available for prompt cash payment at this facility.

Insurance Median

$183

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: $365 (411%)

Insurance Median: $183 (206%)

Cash: $365 (411% of Medicare)

Ins. Median: $183 (206% 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 206% of the Medicare baseline (a markup of 106%). 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
Inland Empire Health Plan (Iehp)	$43 - $112	48%
Kaiser Foundation Hospitals	$49 - $542	55%
Alpha Care Medical Group	$112 - $168	126%
Dignity Health	$112 - $168	126%
Epic Health Plan	$112 - $325	126%
Upland Medical Group	$112	126%
Vantage Medical Group	$112 - $168	126%
UnitedHealthcare	$115	129%
Molina Healthcare Of Ca	$141 - $150	159%
Blue Cross Blue Shield	$161	181%
Adventist Health	$162	182%
Heritage Provider Network	$183	206%
Lluh Dept Of Risk Management	$195	219%
Blue Shield Of California	$328 - $497	369%
Global Benefits Group	$487	548%
Temecula Valley Physicians Medical Group	$487	548%
Trivalley Medical Group	$487	548%
Cigna	$520 - $601	585%
Networks By Design	$528	594%
Aetna	$533	599%
Multiplan	$650	731%
Galaxy Health	$690	776%
Prime Health Services	$690	776%

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 $365.
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 Loma Linda University Children's Hospital 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.