CMS Price Transparency Data

X-ray, shoulder

Facility: Mt Sinai Hospital Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $93
  • Cash Discount Price: $194
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mt Sinai Hospital Medical Center is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.05x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$194

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $194 (218%)
Insurance Median: $93 (105%)
Cash: $194 (218% of Medicare)
Ins. Median: $93 (105% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Partners In Hlth - All Plans $10 - $212 11%
Blue Cross Blue Shield $12 - $337 13%
Healthlink Hmo $13 - $265 15%
Healthlink Ppo - All Other Plans $13 - $265 15%
Compsych Ip/Op Only - All Plans $16 - $318 18%
Hfn Platinum $17 - $344 19%
Multiplan Primary Ntwrk/Phcs - All Other Plans $18 - $371 20%
Hfn Epo $21 - $424 24%
Multiplan Complementary Ntwrk $21 - $424 24%
Hfn Ppo - All Other Plans $23 - $466 26%
Ambetter / Centene $27 - $556 30%
Oscar - All Plans $27 - $556 30%
Cigna $32 - $654 36%
Aetna $59 - $1,196 66%
Humana $82 - $1,662 92%
Family Health Network Mcaid - All Plans $84 94%
Molina Mcaid $88 99%
Tricare $90 101%
Va Healthnet - All Plans $90 101%
Advocate Physician Prtnrs Mcr $93 105%
Cenpatico Illinicare Dual $93 105%
Cenpatico Illinicare Mcr - All Other Plans $93 105%
Lawndale Christian - All Plans $93 105%
Meridian/Harmony D-Snp - All Plans $93 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $93 105%
UnitedHealthcare $93 - $283 105%
Harmony Behavioral Htlh - All Plans $96 108%
Zing Mcr Adv - All Plans $97 109%
Molina Mcr - All Other Plans $98 110%
Advocate Physician Prtnrs - All Other Plans $103 116%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals