CMS Price Transparency Data

X-ray, shoulder

Facility: Poudre Valley Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $214
Cash Discount Price: $254
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Poudre Valley Hospital is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.41x the Medicare baseline. Located in 1024 S Lemay Ave, Fort Collins, CO.

Cash / Self-Pay

$254

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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: $254 (286%)

Insurance Median: $214 (241%)

Cash: $254 (286% of Medicare)

Ins. Median: $214 (241% 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 241% of the Medicare baseline (a markup of 141%). 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 - $226	10%
Select Health	$76 - $155	85%
Aetna	$88 - $300	99%
Cigna	$88 - $278	99%
Cms	$88	99%
Devoted Health	$88	99%
Humana	$88	99%
Kaiser	$88	99%
UnitedHealthcare	$88 - $300	99%
Simplified Benefits Administration	$137 - $295	154%
First Health	$214	241%
Denver Health Medical Plan	$283	318%
Midlands Choice	$327	368%
Rocky Mountain Health Plans	$327	368%
Multiplan	$330	371%
Phcs	$330	371%
First Choice Of The Midwest	$352	396%

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 $254.
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 Poudre Valley 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.