CMS Price Transparency Data

X-ray, shoulder

Facility: Ascension St Vincent's Clay County

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $91
Cash Discount Price: $211
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Ascension St Vincent's Clay County is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.02x the Medicare baseline. Located in 1670 St Vincents Way, Middleburg, FL.

Cash / Self-Pay

$211

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $211 (237%)

Insurance Median: $91 (102%)

Cash: $211 (237% of Medicare)

Ins. Median: $91 (102% 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
Aetna	$69 - $181	78%
Humana	$86 - $89	97%
Bc Advantage Mcr Replacement	$88	99%
Blue Cross Blue Shield	$88	99%
Community Hospice	$88	99%
Coventry Mcr Replacement Hmo	$88	99%
Haven Hospice	$88	99%
Medicare (plans)	$88 - $90	99%
Research Study Encore Borland-Groover	$88	99%
Veterans Administration	$88	99%
Wellcare	$88	99%
Cigna	$89 - $211	100%
UnitedHealthcare	$89 - $195	100%
Careplus Mcr Replacement	$90	101%
Inmate Health Care	$110	124%
Bright Health	$119 - $128	134%
Smarthealth	$124	139%
Oscar Health Plan	$141	159%
Employer Direct Healthcare	$155	174%
90 Degree Benefits	$159	179%
Avmed Exchange	$159	179%
Molina Exchange	$164	184%
Occunet	$164 - $199	184%
Ambetter / Centene	$168	189%

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 $211.
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 Ascension St Vincent's Clay County 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.