CMS Price Transparency Data

X-ray, shoulder

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $54
Cash Discount Price: $368
vs. Medicare Baseline: 0.61x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Shriners Hospitals for Children Northern Calif is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $368. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.61x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$368

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $368 (414%)

Insurance Median: $54 (61%)

Cash: $368 (414% of Medicare)

Ins. Median: $54 (61% 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
Ambetter / Centene	$19 - $130	21%
Amerigroup Nv	$20 - $30	22%
Health Plan Of Nv	$23 - $33	26%
Blue Cross Blue Shield	$24 - $37	27%
Soonercare	$29	33%
Aetna	$37 - $113	42%
Central California Alliance For Health	$37	42%
Health Plan Of San Joaquin	$37	42%
Kaiser Permanente	$37 - $100	42%
Molina Healthcare Of Ca	$37	42%
Partnership Healthplan Of Ca	$37	42%
Providence Health Plan	$42	47%
Medicaid / KanCare	$74	83%
Cigna	$75	84%
UnitedHealthcare	$80	90%
Molina Healthcare Of Ms	$85	96%
Amerihealth Caritas Nc	$98	110%
Amerihealth Caritas Sc	$98	110%
Caresource Of Oh	$98	110%
Northbay Healthcare	$113	127%
Sana Benefits	$119 - $158	134%
Sutter Medical Foundation	$124	139%
Health Net Of Ca	$130	146%
Healthchoice Of Oklahoma	$176	198%

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 $368.
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 Shriners Hospitals for Children Northern Calif 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.