CMS Price Transparency Data

X-ray, shoulder

Facility: Rush Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $203
Cash Discount Price: $274
vs. Medicare Baseline: 2.28x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Rush Memorial Hospital is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $274. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.28x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$274

Average discount available for prompt cash payment at this facility.

Insurance Median

$203

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: $274 (308%)

Insurance Median: $203 (228%)

Cash: $274 (308% of Medicare)

Ins. Median: $203 (228% 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 228% of the Medicare baseline (a markup of 128%). 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	$8 - $617	9%
Consumers Life Ins-All Plans	$8 - $604	9%
Humana	$8 - $617	9%
UnitedHealthcare	$8 - $537	9%
Blue Cross Blue Shield	$9 - $491	10%
Caresource Mcr Adv	$9 - $208	10%
My True Advantage - All Plans	$9 - $208	10%
Today'S Option Mcr Adv-All Plans	$9 - $214	10%
Viant Beech St Mcr Adv	$9 - $214	10%
Caresource Marketplace-All Other Plans	$12 - $333	13%
Multiplan-All Plans	$12 - $624	13%
Encore Health Services-All Plans	$15 - $657	17%
Siho-All Plans	$15 - $617	17%
Phcs-All Plans	$17 - $537	19%
Cigna	$29 - $537	33%
Health Net	$29 - $198	33%
Coventry/First Health-All Plans	$41 - $604	46%
Sagamore-All Plans	$617	694%
Community Health Alliance-All Plans	$630	709%

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 $274.
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 Rush 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.