CMS Price Transparency Data

X-ray, shoulder

Facility: Kapiolani Medical Center for Women & Children

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $303
Cash Discount Price: $277
vs. Medicare Baseline: 3.41x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Kapiolani Medical Center for Women & Children is $303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $277. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.41x the Medicare baseline. Located in 1319 Punahou Street, Honolulu, HI.

Cash / Self-Pay

$277

Average discount available for prompt cash payment at this facility.

Insurance Median

$303

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: $277 (312%)

Insurance Median: $303 (341%)

Cash: $277 (312% of Medicare)

Ins. Median: $303 (341% 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 341% of the Medicare baseline (a markup of 241%). 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
Hmsa	$19 - $88	21%
Ohana	$20 - $154	22%
UnitedHealthcare	$28 - $158	31%
Pac Admin	$36	40%
Mdx	$40 - $421	45%
Uha	$43 - $394	48%
Hwmg/Hmaa	$47 - $418	53%
Alohacare	$88 - $154	99%
Kaiser	$88 - $463	99%
Devoted	$92	103%
Mimoh	$293 - $394	330%
Calvos	$314 - $394	353%
Hcha	$334 - $421	376%
Multiplan	$334 - $447	376%
Verdegard	$334 - $421	376%
Mccp	$355 - $447	399%
Coventry	$376 - $473	423%

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 $277.
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 Kapiolani Medical Center for Women & Children 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.