CMS Price Transparency Data

X-ray, shoulder

Facility: Carolina East Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $127
Cash Discount Price: $199
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Carolina East Medical Center is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.43x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$199

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $199 (224%)

Insurance Median: $127 (143%)

Cash: $199 (224% of Medicare)

Ins. Median: $127 (143% 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
Humana	$9 - $83	10%
Inclusive Health (Nchirp)-All Plans	$9 - $83	10%
Tricare	$9 - $522	10%
Pamlico Co Jail-All Plans	$38 - $139	43%
Craven Co. Jail Systems - All Plans	$46 - $176	52%
UnitedHealthcare	$49 - $371	55%
Medcost Ppo Employees And Retirees	$93 - $343	105%
Medcost Ppo Ultra (Employees)	$93 - $327	105%
Blue Cross Blue Shield	$98 - $358	110%
Medcost Ppo City Employees	$103 - $380	116%
Medcost Ppo County Employee	$107 - $395	120%
Benefit Mgmt, Svcs-All Plans	$120 - $444	135%
Aetna	$125 - $462	141%
Medcost Benefit Svc-All Other Plans	$125 - $461	141%
Acs Consult Svc Inc-All Plans	$127 - $471	143%
Medcost Ppo Standard	$127 - $471	143%
Cigna	$128 - $475	144%

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 $199.
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 Carolina East 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.