CMS Price Transparency Data

X-ray, shoulder

Facility: Pender Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $77
Cash Discount Price: $121
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Pender Memorial Hospital is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.87x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$121

Average discount available for prompt cash payment at this facility.

Insurance Median

$77

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: $121 (136%)

Insurance Median: $77 (87%)

Cash: $121 (136% of Medicare)

Ins. Median: $77 (87% 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
Blue Cross Blue Shield	$26 - $99	29%
Humana	$69 - $230	78%
Pace Of The Southern Piedmont	$72	81%
Aetna	$74 - $228	83%
New Hanover Health	$74	83%
Carolina Complete	$75	84%
Cigna	$75 - $118	84%
Nc Department Of Public Safety	$75 - $145	84%
Amerihealth	$77	87%
Wellcare	$77	87%
Ambetter / Centene	$101	114%
Liberty Health	$103	116%
Caresource North Carolina	$107	120%
Plotkin Health	$161	181%
UnitedHealthcare	$196	220%
Medcost	$202 - $225	227%
Employers Choice Network	$260	292%
Three Rivers Provider Network	$260	292%

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 $121.
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 Pender Memorial 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.