CMS Price Transparency Data

X-ray, shoulder

Facility: Montrose Regional Health

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $204
Cash Discount Price: $167
vs. Medicare Baseline: 2.29x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Montrose Regional Health is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.29x the Medicare baseline. Located in 800 S 3Rd St, Montrose, CO.

Cash / Self-Pay

$167

Average discount available for prompt cash payment at this facility.

Insurance Median

$204

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: $167 (188%)

Insurance Median: $204 (229%)

Cash: $167 (188% of Medicare)

Ins. Median: $204 (229% 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 229% of the Medicare baseline (a markup of 129%). 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	$9 - $536	10%
Humana	$9 - $542	10%
Medicare (plans)	$9 - $98	10%
UnitedHealthcare	$9 - $542	10%
Montrose Community Healthplan-All Plans	$13 - $484	15%
United Rocky Mountain Chp-All Other Plans	$15 - $245	17%
United Rocky Mountain Private Plan	$15 - $527	17%
United Rocky Mountain Self Insured	$15 - $542	17%
Sloans Lake Managed Care-All Plans	$21 - $543	24%
Three Rivers-All Plans	$29 - $542	33%
Western Healthcare Alliance-All Plans	$29 - $513	33%
Cigna	$30 - $542	34%
Multiplan-All Plans	$30 - $542	34%
Uchpa - All Plans	$30 - $542	34%
United Rocky Mountain Mcaid	$32 - $222	36%

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 $167.
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 Montrose Regional Health 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.