CMS Price Transparency Data

X-ray, shoulder

Facility: Southwest Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $156
Cash Discount Price: $103
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Southwest Memorial Hospital is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.75x the Medicare baseline. Located in 1311 N Mildred Rd, Cortez, CO.

Cash / Self-Pay

$103

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $103 (116%)

Insurance Median: $156 (175%)

Cash: $103 (116% of Medicare)

Ins. Median: $156 (175% 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
Blue Cross Blue Shield	$47 - $218	53%
Humana	$47 - $236	53%
Rocky Mountain Health Maintenance Organization Inc.	$150 - $228	169%
Aetna	$152 - $232	171%
Cigna	$152 - $232	171%
Cofinity	$152 - $232	171%
Great West	$153 - $233	172%
Kaiser Permanente	$155 - $236	174%
Coventry	$156 - $238	175%
UnitedHealthcare	$156 - $238	175%

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 $103.
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 Southwest Memorial 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.