CMS Price Transparency Data

X-ray, shoulder

Facility: Adventist Health Tulare

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $112
Cash Discount Price: $67
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Adventist Health Tulare is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.26x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$67

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: $67 (75%)

Insurance Median: $112 (126%)

Cash: $67 (75% 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
Blue Shield Mcare	$9 - $112	10%
Fhcn Pace Mcr Adv - All Plans	$9 - $112	10%
Medicare (plans)	$9 - $112	10%
Tricare	$9 - $112	10%
UnitedHealthcare	$9 - $710	10%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot	$9	10%
Ah Employee Health Plan - All Plans	$10 - $201	11%
Incentive Hlth - All Plans	$10 - $201	11%
Cal Forensic Med Grp - All Plans	$12 - $146	13%
Cigna	$12 - $454	13%
Hs Interplan-All Plans	$12 - $657	13%
Blue Shield Epn	$13 - $310	15%
Healthnet Hmo/Ppo - All Other Plans	$13 - $298	15%
Blue Cross Blue Shield	$14 - $166	16%
Blue Shield-All Other Plans	$14 - $428	16%
Aetna	$19 - $119	21%
Ccipa Medi-Cal - All Plans	$26 - $48	29%
Healthnet Medi-Cal	$26 - $49	29%
Medi-Cal	$26 - $37	29%
Upn-United Physcn Ntwrk Mcal Profee Only	$26	29%
Dignity Mcal Op Only	$41	46%
Independence Op Only - All Plans	$41	46%
Dignity Mcr Op Only - All Other Plans	$112	126%
Prime Health - All Plans	$112	126%
Prison Hlthcre - All Plans	$143	161%
Bright Health - All Plans	$162	182%
Western Growers - All Plans	$300 - $451	337%
Network By Design-All Plans	$457 - $686	514%
Multiplan - All Plans	$555 - $833	624%

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 $67.
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 Tulare 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.