CMS Price Transparency Data

X-ray, shoulder

Facility: Ascension St Vincent Kokomo

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $20
Cash Discount Price: $293
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Ascension St Vincent Kokomo is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $293. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.22x the Medicare baseline. Located in 1907 W Sycamore St, Kokomo, IN.

Cash / Self-Pay

$293

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $293 (330%)

Insurance Median: $20 (22%)

Cash: $293 (330% of Medicare)

Ins. Median: $20 (22% 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.

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
UnitedHealthcare	$4 - $39	4%
Blue Cross Blue Shield	$7 - $435	8%
Medicaid / KanCare	$7 - $21	8%
Mhs Care Connect	$7 - $21	8%
Encore Exclusive	$20	22%
Patoka Valley Tier 1	$20	22%
Patoka Valley Tier 2	$20	22%
Smarthealth Ppo	$35	39%
Smarthealth Ppo/Hdhp 20161001	$35	39%
Aetna	$250	281%

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 $293.
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 Ascension St Vincent Kokomo 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.