CMS Price Transparency Data

X-ray, shoulder

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $226
Cash Discount Price: $273
vs. Medicare Baseline: 2.54x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Sarah D Culbertson Memorial Hospital is $226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.54x the Medicare baseline. Located in 238 South Congress Street, Rushville, IL.

Cash / Self-Pay

$273

Average discount available for prompt cash payment at this facility.

Insurance Median

$226

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: $273 (307%)

Insurance Median: $226 (254%)

Cash: $273 (307% of Medicare)

Ins. Median: $226 (254% 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 254% of the Medicare baseline (a markup of 154%). 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
Aetna	$9 - $464	10%
Blue Cross Blue Shield	$9 - $505	10%
Molina Mmai-All Other Plans	$9 - $221	10%
UnitedHealthcare	$9 - $464	10%
Cigna	$11 - $381	12%
Multiplan/Phcs-All Plans	$27 - $464	30%
Health Dynamics-All Plans	$74 - $464	83%
Preferred Medical Claims Solution-All Plans	$83 - $464	93%
Three Rivers Provider Network-All Plans	$83 - $464	93%
Corvel-All Plans	$183	206%
Meridian Hp Mcaid-All Plans	$183 - $297	206%
Molina Healthcare Mcaid	$183 - $297	206%
Humana	$221	249%
Beech Street-All Plans	$464	522%
Encompass-All Plans	$464	522%
Healthlink-All Plans	$464	522%
Hfn Epo	$464	522%
Hfn Ppo Ip/Op Only-All Other Plans	$464	522%
Wexford Ip/Op Only-All Plans	$464	522%
Healthsmart-All Plans	$489	550%

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 $273.
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 Sarah D Culbertson Memorial Hospital 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.