CMS Price Transparency Data

X-ray, shoulder

Facility: Valley Children's Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $296
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 3.33x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Valley Children's Hospital is $296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.33x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$296

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%)
Insurance Median: $296 (333%)
Ins. Median: $296 (333% 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 333% of the Medicare baseline (a markup of 233%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Allcare Ipa $37 - $270 42%
Kaiser $38 - $350 43%
Dignity Ipa_Formerly Img $52 58%
La Salle Ipa $52 58%
Sante Ipa $52 58%
Central Valley Medical Providers Ipa $56 - $270 63%
Sequoia Health Ipa $56 63%
Univseral Healthcare Ipa $56 63%
United Physicians Network Ipa $58 - $270 65%
Community Care Ipa $59 66%
Adventist $66 74%
Blue Cross Blue Shield $68 - $306 76%
Cencal Health $74 83%
Kern Family Health Care $74 83%
Central California Alliance For Health $76 85%
Health Net $190 - $353 214%
Dignity Health Central Coast $267 300%
Community Health $296 333%
Stanislaus Partners In Health $296 333%
Physicians Choice Medical Group $302 340%
Health Plan Of San Joaquin $323 363%
UnitedHealthcare $331 372%
Fowler Packing $334 376%
Dignity (Formerly Managed Care Systems) $340 382%
Kern Legacy $350 394%
Blue Shield $360 - $409 405%
Aetna $361 406%
First Health Formerly Coventry $399 449%
Bakersfield Family Medical Group $404 454%
Network By Design $418 470%
Community Care Health Plan $431 485%
Health Smart $431 485%
Key Medical Ipa $431 485%
Sutter Health $458 515%
Multiplan $516 580%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens