CMS Price Transparency Data

X-ray, shoulder

Facility: Nkc Health

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $291
Cash Discount Price: $211
vs. Medicare Baseline: 3.27x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Nkc Health is $291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.27x the Medicare baseline. Located in 2800 Clay Edwards Drive, North Kansas City, MO.

Cash / Self-Pay

$211

Average discount available for prompt cash payment at this facility.

Insurance Median

$291

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: $211 (237%)

Insurance Median: $291 (327%)

Cash: $211 (237% of Medicare)

Ins. Median: $291 (327% 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 327% of the Medicare baseline (a markup of 227%). 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	$22 - $653	25%
Quiktrip	$69 - $582	78%
Ambetter / Centene	$77	87%
UnitedHealthcare	$87 - $235	98%
Humana	$89	100%
Occunet Network	$175 - $180	197%
Oscar	$180 - $245	202%
Centrus Health Direct	$194 - $231	218%
Centivo	$196 - $291	220%
Wellfit	$196 - $315	220%
Cigna	$228 - $456	256%
Aetna	$246 - $793	277%
Multiplan	$340 - $776	382%

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 $211.
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 Nkc Health 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.