CMS Price Transparency Data

X-ray, shoulder

Facility: Lost Rivers Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $274
Cash Discount Price: $340
vs. Medicare Baseline: 3.08x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Lost Rivers Medical Center is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $340. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.08x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$340

Average discount available for prompt cash payment at this facility.

Insurance Median

$274

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: $340 (382%)

Insurance Median: $274 (308%)

Cash: $340 (382% of Medicare)

Ins. Median: $274 (308% 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 308% of the Medicare baseline (a markup of 208%). 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
Provider Network Of America-All Plans	$160	180%
Select Health Brightpath-All Other Plans	$241	271%
Tricare	$241	271%
Ihcn Brightpath-All Other Plans	$254	286%
Va Pccc-All Plans	$260	292%
Blue Cross Blue Shield	$268 - $425	301%
Humana	$268 - $425	301%
Ihcn Brightpath Mcr Adv	$268	301%
Molina Mcr Adv-All Plans	$268	301%
Pacificsource Mcr Adv	$268	301%
Regence/Brightpth Slhp Mcr	$268	301%
Select Health Mcr Adv	$268	301%
Prime Hlth Mcr Adv	$281	316%
Aetna	$289 - $400	325%
Cigna	$395	444%
First Choice-All Plans	$395	444%
Pacificsource Navigator-All Other Plans	$404	454%
UnitedHealthcare	$404	454%
Altius Health Plan-All Plans	$412	463%
Regence Blue Shield-All Other Plans	$1,564	1759%

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 $340.
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 Lost Rivers 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.