CMS Price Transparency Data

X-ray, shoulder

Facility: Doctors Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $269
Cash Discount Price: $2,015
vs. Medicare Baseline: 3.03x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Doctors Hospital is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,015. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.03x the Medicare baseline. Located in 3651 Wheeler Road, Augusta, GA.

Cash / Self-Pay

$2,015

Average discount available for prompt cash payment at this facility.

Insurance Median

$269

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: $2,015 (2266%)

Insurance Median: $269 (303%)

Cash: $2,015 (2266% of Medicare)

Ins. Median: $269 (303% 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 303% of the Medicare baseline (a markup of 203%). 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	$13 - $71	15%
Blue Choice	$37	42%
Health One Alliance	$38	43%
Aetna	$56 - $1,481	63%
Ambetter / Centene	$118	133%
United	$182 - $1,209	205%
Amerigroup	$191 - $381	215%
Prime Health	$221	249%
Rockport United Network	$226	254%
Identity Mco	$231	260%
Absolute Total Care	$242 - $483	272%
Nhc Advantage	$255 - $510	287%
Pruitt Health	$255 - $510	287%
Peach State	$269 - $537	303%
Wellcare	$269 - $537	303%
Centurion	$372 - $744	418%
Americas 1St Choice	$376 - $752	423%
Medcost	$673 - $1,716	757%
Kaiser Permanente	$734 - $1,468	826%
Multiplan	$806 - $2,417	907%
Performax	$913 - $1,826	1027%
First Health	$1,007 - $2,015	1133%
Employer'S Health Network	$1,074 - $2,149	1208%
Novanet	$1,209 - $2,417	1360%

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 $2,015.
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 Doctors 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.