CMS Price Transparency Data

X-ray, shoulder

Facility: Transylvania Regional Hospital, Inc

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $209
  • Cash Discount Price: $511
  • vs. Medicare Baseline: 2.35x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Transylvania Regional Hospital, Inc is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $511. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.35x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.
Cash / Self-Pay
$511

Average discount available for prompt cash payment at this facility.

Insurance Median
$209

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: $511 (575%)
Insurance Median: $209 (235%)
Cash: $511 (575% of Medicare)
Ins. Median: $209 (235% 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 235% of the Medicare baseline (a markup of 135%). 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.

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 $96 - $102 108%
United $98 - $230 110%
Wellcare $99 111%
Amerihealth $100 112%
Partners Health Management $101 114%
Vaya Health $101 114%
Apex Health $102 115%
Aetna $133 - $369 150%
Cigna $187 - $260 210%
Amerihealth Caritas $209 235%
Caresource $225 253%
Medcost $286 - $434 322%
Magellan $306 344%
Magellan Behavioral Health $306 344%
Multiplan $409 460%
Avalon Administrative Services $434 488%
Prime Health $450 - $460 506%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 90 Hospital Drive Po Box 1116, Brevard, NC 28712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals