CMS Price Transparency Data

X-ray, shoulder

Facility: North Carolina Baptist Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $146
Cash Discount Price: $222
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at North Carolina Baptist Hospital is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.64x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$222

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $222 (250%)

Insurance Median: $146 (164%)

Cash: $222 (250% of Medicare)

Ins. Median: $146 (164% 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.

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
Aetna	$85 - $387	96%
Apex	$85	96%
Blue Cross Blue Shield	$85 - $154	96%
Cigna	$85 - $273	96%
Devoted	$85	96%
Healthteam	$85	96%
Medcost	$85 - $303	96%
UnitedHealthcare	$85 - $157	96%
Wellcare	$85 - $104	96%
Humana	$86 - $249	97%
Medicare (plans)	$86	97%
Amerihealth	$97 - $123	109%
Carolina Complete	$97 - $103	109%
Health Blue	$97 - $103	109%
Partners	$97 - $103	109%
Liberty	$98	110%
Vaya	$98 - $104	110%
Alliance	$99 - $105	111%
Trillium	$100 - $106	112%
Ambetter / Centene	$116 - $123	130%
Oscar	$129 - $164	145%
Directnet	$255 - $269	287%
Cone Health	$302 - $318	340%
Healthgram	$302 - $318	340%
First Carolina Care	$345 - $364	388%
Private Healthcare Systems	$353 - $373	397%
Multiplan	$388 - $410	436%

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 $222.
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 North Carolina Baptist 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.