CMS Price Transparency Data

X-ray, shoulder

Facility: Sanford Canby Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $393
Cash Discount Price: $384
vs. Medicare Baseline: 4.42x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Sanford Canby Medical Center is $393. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $384. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.42x the Medicare baseline. Located in 112 St Olaf Avenue South, Canby, MN.

Cash / Self-Pay

$384

Average discount available for prompt cash payment at this facility.

Insurance Median

$393

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: $384 (432%)

Insurance Median: $393 (442%)

Cash: $384 (432% of Medicare)

Ins. Median: $393 (442% 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 442% of the Medicare baseline (a markup of 342%). 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
Ucare	$92 - $422	103%
Blue Cross Blue Shield	$116 - $393	130%
Sanford Health Plan Align	$219	246%
Aetna	$237 - $417	267%
Health Partners	$237 - $384	267%
Medicare (plans)	$237	267%
UnitedHealthcare	$237 - $401	267%
Primewest	$242 - $264	272%
Security Health Plan	$264	297%
Sanford Health Plan	$379 - $446	426%
Medica	$422 - $454	475%
Cigna	$432	486%
First Choice Health Network	$432	486%
Healthez	$432	486%
Multiplan	$432	486%

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 $384.
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 Sanford Canby Medical Center 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.