CMS Price Transparency Data

X-ray, shoulder

Facility: Essentia Health

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $159
Cash Discount Price: $265
vs. Medicare Baseline: 1.79x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Essentia Health is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.79x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.

Cash / Self-Pay

$265

Average discount available for prompt cash payment at this facility.

Insurance Median

$159

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: $265 (298%)

Insurance Median: $159 (179%)

Cash: $265 (298% of Medicare)

Ins. Median: $159 (179% 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
Advocare/Security Health	$88	99%
Blue Cross Blue Shield	$88 - $238	99%
Freedom Blue Ppo	$88	99%
Healthpartners Care Msho / Mcr Adv	$88	99%
Imcare Msho Pcc Prime	$88	99%
Imcare Msho Ref Req	$88	99%
Itasca Med Care	$88	99%
Medica Advantage Solutions	$88	99%
Medica Msho/Dual Solutions	$88	99%
Medica Prime Solution Group	$88	99%
Medicare (plans)	$88	99%
Nd Va Administration	$88	99%
Platinum Blue/Vantage Blue	$88	99%
Primewest	$88	99%
Primewest Msho	$88	99%
Secure Blue Msho	$88	99%
Ubh Cost Plan	$88	99%
Ubh Msho	$88	99%
Ucare Msho	$88	99%
UnitedHealthcare	$88 - $281	99%
Medica Access	$95	107%
Healthpartners Care Pmap	$137	154%
Sanford Health Plan	$151 - $159	170%
Medica	$196 - $217	220%
Medica Uplan	$196	220%
Medica Choice	$224	252%
Ucare	$232	261%
Cigna	$237	267%
Healthpartners	$237	267%
Healthpartners Pcc Prime	$237	267%
Wea	$254 - $272	286%
America'S Ppo	$274	308%
Wps	$293 - $297	330%
Aetna	$300	337%

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 $265.
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 Essentia Health 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.