CMS Price Transparency Data

X-ray, shoulder

Facility: West Valley Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $604
Cash Discount Price: $1,143
vs. Medicare Baseline: 6.79x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at West Valley Medical Center is $604. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,143. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.79x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$1,143

Average discount available for prompt cash payment at this facility.

Insurance Median

$604

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: $1,143 (1286%)

Insurance Median: $604 (679%)

Cash: $1,143 (1286% of Medicare)

Ins. Median: $604 (679% 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 679% of the Medicare baseline (a markup of 579%). 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	$7 - $1,493	8%
Molina	$7 - $19	8%
Regence	$181	204%
United	$182 - $938	205%
Select Health Idaho (Eirmc Only)	$228 - $501	256%
Corizon Health	$264 - $582	297%
True Blue	$282 - $621	317%
Cigna	$400 - $880	450%
Pacificsource Health	$427 - $938	480%
Moda	$445 - $979	501%
St Luke'S Health Partners	$465 - $1,022	523%
Aetna	$565 - $1,243	635%
Four Rivers Hospice	$572 - $1,257	643%
Multiplan	$572 - $1,257	643%
Humana	$600 - $1,320	675%
Geha Ppo Usa	$607 - $1,336	683%
Coventry First Health	$643 - $1,415	723%
St Alphonsus Health	$643 - $1,415	723%

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 $1,143.
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 West Valley 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.