CMS Price Transparency Data
X-ray, shoulder
Facility: Mercy Hospital Aurora
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $344
- Cash Discount Price: $264
- vs. Medicare Baseline: 3.87x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy Hospital Aurora is $344. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.87x the Medicare baseline. Located in 500 Porter Avenue, Aurora, MO.
Cash / Self-Pay
$264
Average discount available for prompt cash payment at this facility.
Insurance Median
$344
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: $264 (297%)
Insurance Median: $344 (387%)
Cash: $264 (297% of Medicare)
Ins. Median: $344 (387% 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 387% of the Medicare baseline (a markup of 287%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $20 - $292 | 22% |
| Medicare (plans) | $82 - $170 | 92% |
| Aetna | $115 - $513 | 129% |
| Blue Cross Blue Shield | $115 - $576 | 129% |
| Cherokee Nation Health Serv Contracted [320066] | $115 - $164 | 129% |
| Cigna | $115 - $490 | 129% |
| Cross Timbers Hospice [20098] | $115 - $164 | 129% |
| Elara Caring Aspire Hospice [20433] | $115 - $164 | 129% |
| Globalhealth Contracted [320145] | $115 - $164 | 129% |
| Halo Hcr Inc Hospice Contracted [320432] | $115 - $164 | 129% |
| Halo Hcr Inc Hospice [20432] | $115 - $164 | 129% |
| Humana | $115 - $490 | 129% |
| Indian Health Service Contracted [320198] | $115 - $164 | 129% |
| Kindful Hospice Contracted [320434] | $115 - $164 | 129% |
| Kindful Hospice [20434] | $115 - $164 | 129% |
| Medical Associates Health Contracted [320444] | $115 - $164 | 129% |
| Mercy Hospice Okc [20252] | $115 - $164 | 129% |
| Mercy Mgd Behavioral Health Contracted [320259] | $115 - $164 | 129% |
| Pace Of The Ozarks Contracted [320518] | $115 - $164 | 129% |
| Provider Partners Health Plans Contracted [320450] | $115 - $164 | 129% |
| Qual Choice Contracted [320325] | $115 - $164 | 129% |
| UnitedHealthcare | $115 - $547 | 129% |
| Dept Of Veteran Affairs Contracted [320106] | $118 - $168 | 133% |
| Tricare | $118 - $168 | 133% |
| Healthscope Contracted [320182] | $149 - $212 | 168% |
| Centivo Contracted [320505] | $162 - $230 | 182% |
| Administrative Payor Contracted [320005] | $182 - $259 | 205% |
| Ambetter / Centene | $205 - $292 | 231% |
| Home State Health Plan Contracted [320187] | $205 - $292 | 231% |
| Novasys Contracted [320285] | $205 - $292 | 231% |
| Healthlink Contracted [320179] | $263 - $518 | 296% |
| Preferred Health Plan Contracted [320522] | $263 - $374 | 296% |
| Health Systems Inc Contracted [320174] | $324 - $461 | 364% |
| Insurance System Inc Contracted [320465] | $324 - $461 | 364% |
| Point C Contracted [320238] | $324 - $490 | 364% |
| Point C [20238] | $324 - $461 | 364% |
| Workers Comp [20426] | $324 - $490 | 364% |
| Medica Contracted [320239] | $343 - $487 | 386% |
| 90 Degree Benefits Contracted [320436] | $344 - $490 | 387% |
| Aither Health Contracted [320449] | $344 - $490 | 387% |
| American Healthcare Alliance Contracted [320020] | $344 - $490 | 387% |
| Auxiant Contracted [320462] | $344 - $490 | 387% |
| Benefit Management Contracted [320052] | $344 - $490 | 387% |
| Ebms Contracted [320493] | $344 - $490 | 387% |
| Edison Health Solutions Contracted [320502] | $344 - $490 | 387% |
| Evolutions Health Care Contracted [320124] | $344 - $490 | 387% |
| First Health Contracted [320128] | $344 - $490 | 387% |
| Imagine 360 Contracted [320494] | $344 - $490 | 387% |
| Mercy Benefit Admin Contracted [320251] | $344 - $490 | 387% |
| Reflect Health Contracted [320492] | $344 - $490 | 387% |
| Show-Me Health Administrators Contracted [320483] | $344 - $490 | 387% |
| United Medical Resources Contracted [320454] | $344 - $507 | 387% |
| Yuzu Health Contracted [320521] | $344 - $490 | 387% |
| Usa Managed Care Org Contracted [320429] | $356 - $507 | 400% |
| Multiplan Contracted [320270] | $385 - $547 | 433% |
| Private Health Care Systems Contracted [320320] | $385 - $547 | 433% |