CMS Price Transparency Data

X-ray, shoulder

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $542
Cash Discount Price: $1,688
vs. Medicare Baseline: 6.10x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at HCA Healthone Presbyterian St Luke's is $542. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,688. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.10x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$1,688

Average discount available for prompt cash payment at this facility.

Insurance Median

$542

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: $1,688 (1899%)

Insurance Median: $542 (610%)

Cash: $1,688 (1899% of Medicare)

Ins. Median: $542 (610% 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 610% of the Medicare baseline (a markup of 510%). 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	$22 - $1,664	25%
United	$138 - $1,012	155%
Pinnacol Workers Comp	$140	157%
Multiplan	$146 - $2,023	164%
Vail Health	$171 - $342	192%
Rocky Mountain Health Plan	$182	205%
Kaiser	$226 - $584	254%
Cigna	$258 - $1,439	290%
Aetna	$338 - $1,187	380%
Bright Health	$338 - $674	380%
Emerging Therapy Solutions	$542 - $1,439	610%
Kaiser National Transplant	$542 - $1,079	610%
Colorado Program For Children With Special Needs	$575 - $1,146	647%
Western Plains Community Health	$733 - $1,461	824%
Northcare	$790 - $1,574	889%
Physician Health Partners	$790 - $1,574	889%
Medical Development International	$903 - $1,798	1016%
Prime Health	$1,015 - $2,023	1142%

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 $1,688.
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 HCA Healthone Presbyterian St Luke's 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.