CMS Price Transparency Data

X-ray, shoulder

Facility: Novant Health Forsyth Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $214
Cash Discount Price: $205
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Novant Health Forsyth Medical Center is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.41x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$205

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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: $205 (231%)

Insurance Median: $214 (241%)

Cash: $205 (231% of Medicare)

Ins. Median: $214 (241% 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 241% of the Medicare baseline (a markup of 141%). 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	$26 - $293	29%
Carolina Complete	$62 - $79	70%
Nc Department Of Public Safety	$62 - $169	70%
Amerihealth	$63 - $81	71%
UnitedHealthcare	$63 - $287	71%
Wellcare	$63 - $81	71%
Humana	$84 - $333	94%
Pace Of The Southern Piedmont	$84	94%
Aetna	$87 - $342	98%
Cigna	$87 - $254	98%
Liberty Health	$89	100%
Caresource North Carolina	$134 - $171	151%
Atlantic Corporation Dba Atlantic Packaging	$189 - $241	213%
Plotkin Health	$201 - $256	226%
Amps	$218 - $278	245%
Medcost	$285 - $401	321%
Primary Physician Care	$295 - $376	332%
Beechstreet	$302 - $384	340%
Multiplan	$302 - $384	340%
Phcs	$302 - $384	340%
Employers Choice Network	$325 - $414	366%
Three Rivers Provider Network	$325 - $414	366%

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 $205.
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 Novant Health Forsyth 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.