X-ray, shoulder
Facility: Stafford County Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $201
- Cash Discount Price: $205
- vs. Medicare Baseline: 2.26x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 226% of the Medicare baseline (a markup of 126%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Health Partners-All Plans | $191 - $199 | 215% |
| Va Ccn-All Plans | $201 - $209 | 226% |
| Humana | $201 - $209 | 226% |
| Medica Mcr- All Plans | $201 - $209 | 226% |
| UnitedHealthcare | $201 - $209 | 226% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Stafford County Hospital, the cash price is $205.00, which matches the facility's median negotiated rate of $201.00 and the state average. This service is significantly more expensive than the Medicare benchmark of $88.91, reflecting a markup of 2.3 times the federal rate. While commercial insurance plans like Health Partners, Humana, and UnitedHealthcare negotiate rates ranging from $191 to $209, these amounts remain well above the Medicare baseline. For patients with high-deductible plans, paying the cash price of $205.00 upfront may be more cost-effective than using insurance, as the negotiated rates often exceed the cash price and could result in higher out-of-pocket costs if the patient's deductible has not yet been met.
Patients should verify whether "self-pay" or "prompt-pay" discounts are available before scheduling, as these programs can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. It is important to request a waiver of insurance submission prior to check-in to ensure the facility applies the cash rate rather than submitting a claim that could void the discount. Additionally, consumers should avoid accepting summary bills and instead demand a full itemized statement to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. By comparing the facility's rates directly to the Medicare benchmark and actively seeking prompt-pay options, patients can avoid unexpected balance billing and ensure they are paying a fair price for their care.