CMS Price Transparency Data

X-ray, shoulder

Facility: Knox County Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $169
Cash Discount Price: $443
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Knox County Hospital is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $443. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.90x the Medicare baseline. Located in 80 Hospital Drive, Barbourville, KY.

Cash / Self-Pay

$443

Average discount available for prompt cash payment at this facility.

Insurance Median

$169

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: $443 (498%)

Insurance Median: $169 (190%)

Cash: $443 (498% of Medicare)

Ins. Median: $169 (190% 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
Aetna	$83 - $868	93%
Blue Cross Blue Shield	$83 - $862	93%
Humana	$83 - $169	93%
UnitedHealthcare	$84 - $440	94%
Wellcare Of Kentucky	$84 - $169	94%
Passport Molina	$85 - $171	96%
Caresoure Kentucky	$319 - $641	359%

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 $443.
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 Knox County 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.