CMS Price Transparency Data

X-ray, shoulder

Facility: Barnes Jewish Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $252
Cash Discount Price: $233
vs. Medicare Baseline: 2.83x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Barnes Jewish Hospital is $252. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.83x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$233

Average discount available for prompt cash payment at this facility.

Insurance Median

$252

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: $233 (262%)

Insurance Median: $252 (283%)

Cash: $233 (262% of Medicare)

Ins. Median: $252 (283% 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 283% of the Medicare baseline (a markup of 183%). 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	$52 - $338	58%
Consociate [478]	$67	75%
Sarah Bush Lincoln [636]	$67	75%
Humana	$68	76%
Cigna	$79 - $310	89%
Aetna	$105 - $291	118%
Allied Benefits [498]	$105 - $288	118%
Coresource [497]	$105	118%
Fmh Benefit Service Inc [222]	$105	118%
Mail Handlers [495]	$105	118%
Apwu Health Plan [216]	$109	123%
Nalc Health Benefit Plan [242]	$109	123%
Priority Health [648]	$109	123%
Healthlink [225]	$188 - $293	211%
Cox Health Systems Insurance Company [220]	$213 - $252	240%
Health Alliance [224]	$213	240%
Hope Trust [806]	$225	253%
Healthscope Benefits [258]	$237 - $380	267%
Med-Pay [480]	$252 - $291	283%
Unicare [568]	$252 - $293	283%
First Health Commercial [734]	$288	324%
UnitedHealthcare	$288 - $380	324%
Beechstreet [551]	$291	327%
Detego Health [868]	$291	327%
Health Systems Inc [620]	$291	327%
Healthcare Sol Mercy [609]	$291	327%
Multiplan Commercial [737]	$291	327%
Multiplan [240]	$291	327%
Phcs [244]	$291 - $310	327%
Preferred Health Professionals [561]	$293	330%
Medica [661]	$310	349%
Hfn [563]	$330	371%

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 $233.
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 Barnes Jewish 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.