CMS Price Transparency Data

X-ray, shoulder

Facility: Abrom Kaplan Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $188
Cash Discount Price: $109
vs. Medicare Baseline: 2.11x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Abrom Kaplan Memorial Hospital is $188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.11x the Medicare baseline. Located in 1310 West Seventh Street, Kaplan, LA.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$188

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: $109 (123%)

Insurance Median: $188 (211%)

Cash: $109 (123% of Medicare)

Ins. Median: $188 (211% 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 211% of the Medicare baseline (a markup of 111%). 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
Blue Cross Blue Shield	$42 - $218	47%
Verity Commercial And First Choice Network	$85 - $169	96%
Aetna	$109 - $376	123%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$109 - $218	123%
Humana	$109 - $376	123%
Medicare (plans)	$109 - $218	123%
Ochsner Health Plan	$109 - $218	123%
UnitedHealthcare	$109 - $376	123%
Wellcare Of Louisiana	$109 - $218	123%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$112 - $224	126%
Tricare	$127 - $254	143%
Cigna	$169 - $339	190%
Zelis	$169 - $339	190%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$188 - $376	211%
Healthy Blue (Healthy Louisiana)	$188 - $376	211%
Louisiana Healthcare Connections (Healthy Louisiana)	$188 - $376	211%

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 $109.
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 Abrom Kaplan 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.