CMS Price Transparency Data

X-ray, shoulder

Facility: Piedmont Athens Regional Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $93
Cash Discount Price: $217
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Piedmont Athens Regional Medical Center is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $217. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.05x the Medicare baseline. Located in 1199 Prince Avenue, Athens, GA.

Cash / Self-Pay

$217

Average discount available for prompt cash payment at this facility.

Insurance Median

$93

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: $217 (244%)

Insurance Median: $93 (105%)

Cash: $217 (244% of Medicare)

Ins. Median: $93 (105% 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
Cigna	$41 - $57	46%
Blue Cross Blue Shield	$47 - $84	53%
Alliant Health Plans Of Georgia [10952]	$58	65%
Medicaid / KanCare	$77 - $81	87%
Aetna	$93	105%
UnitedHealthcare	$216	243%
Kaiser [10500]	$398	448%
First Health [10303]	$507	570%
Novanet [10819]	$543	611%
Beechstreet [10800]	$594	668%
Multiplan [10600]	$594	668%
Phcs [10601]	$594	668%

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 $217.
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 Piedmont Athens Regional Medical Center 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.