CMS Price Transparency Data

X-ray, shoulder

Facility: Valor Health

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $361
Cash Discount Price: $395
vs. Medicare Baseline: 4.06x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Valor Health is $361. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $395. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.06x the Medicare baseline. Located in 1202 East Locust Street, Emmett, ID.

Cash / Self-Pay

$395

Average discount available for prompt cash payment at this facility.

Insurance Median

$361

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: $395 (444%)

Insurance Median: $361 (406%)

Cash: $395 (444% of Medicare)

Ins. Median: $361 (406% 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 406% of the Medicare baseline (a markup of 306%). 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
Tricare	$189	213%
Aetna	$195 - $347	219%
Blue Cross Blue Shield	$195 - $407	219%
Blue Shield Mcr Adv	$195	219%
Humana	$195 - $407	219%
Molina Mcr Adv - All Plans	$195	219%
Regence Bs Triwest - All Plans	$195	219%
UnitedHealthcare	$195 - $384	219%
Pacificsource Mcr Adv	$205	231%
Cigna	$376 - $384	423%
Moda Health - All Plans	$395	444%
Pacificsource Comm - All Other Plans	$395	444%
Select Health Comm - All Other Plans	$395	444%
Blue Shield Comm - All Other Plans	$1,246	1401%

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 $395.
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 Valor Health 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.