CMS Price Transparency Data

X-ray, shoulder

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $453
Cash Discount Price: $788
vs. Medicare Baseline: 5.10x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Children's Healthcare of Atlanta at Scottish Rite is $453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $788. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.10x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$788

Average discount available for prompt cash payment at this facility.

Insurance Median

$453

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: $788 (886%)

Insurance Median: $453 (510%)

Cash: $788 (886% of Medicare)

Ins. Median: $453 (510% 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 510% of the Medicare baseline (a markup of 410%). 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
Peachstate [43]	$219 - $439	246%
Caresource [61]	$225 - $451	253%
Amerigroup [102]	$228 - $455	256%
Cigna	$347 - $694	390%
Blue Cross Blue Shield	$348 - $1,025	391%
United [5]	$348 - $697	391%
Ambetter / Centene	$351 - $703	395%
Oscar [228]	$352 - $704	396%
Aetna	$353 - $707	397%
Caresource Marketplace Bronze/Silver/Gold [60]	$357 - $713	402%
Kaiser [6]	$357 - $715	402%
Sidecar Health [236]	$362 - $724	407%
Coventry [9]	$368 - $737	414%
Direct Employer Agreements [72]	$368 - $892	414%
First Health [74]	$394 - $788	443%
Northeast Georgia Heatlh System [808]	$394 - $788	443%
Veracity Benefits [809]	$394 - $788	443%
Phcs [93]	$446 - $892	502%
Secure Health [340]	$446 - $892	502%
Beech Street [71]	$472 - $945	531%
Multiplan [92]	$514 - $1,029	578%
Novanet [41]	$525 - $1,050	590%

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 $788.
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 Children's Healthcare of Atlanta at Scottish Rite 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.