CMS Price Transparency Data

X-ray, shoulder

Facility: Memorial Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $461
Cash Discount Price: $769
vs. Medicare Baseline: 5.19x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Memorial Medical Center is $461. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $769. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.19x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$769

Average discount available for prompt cash payment at this facility.

Insurance Median

$461

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: $769 (865%)

Insurance Median: $461 (519%)

Cash: $769 (865% of Medicare)

Ins. Median: $461 (519% 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 519% of the Medicare baseline (a markup of 419%). 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	$33 - $769	37%
Healthlink	$50 - $484	56%
Veterans Administration	$66	74%
Medicaid / KanCare	$70	79%
Molina	$72	81%
Aetna	$92 - $584	103%
Health Alliance	$92 - $500	103%
Medicare (plans)	$92 - $769	103%
Tricare	$92	103%
UnitedHealthcare	$92 - $477	103%
Humana	$96 - $461	108%
Commercial Workers Compensation	$192	216%
Illinois Workers Compensation	$202	227%
Current Health Network Ppo	$346	389%
Cigna	$404	454%
Phcs/Multiplan	$415 - $461	467%
6 Degrees Health	$461	519%
Hopetrust	$461	519%
Hst	$461	519%
Magellan	$461	519%
Consociate	$500	562%
Hfn	$500	562%
Preferred Plan	$577	649%
Soi Mcfarland	$577	649%
Soi Rushville	$577	649%
Corvel	$615	692%
Methodist First Choice	$615	692%
Mutual Medical Plans	$654	736%
Liability	$769	865%

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 $769.
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 Memorial 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.