CMS Price Transparency Data
X-ray, shoulder
Facility: Mount Carmel East & West
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $278
- Cash Discount Price: $323
- vs. Medicare Baseline: 3.13x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mount Carmel East & West is $278. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $323. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.13x the Medicare baseline. Located in 6001 East Broad Street, Columbus, OH.
Cash / Self-Pay
$323
Average discount available for prompt cash payment at this facility.
Insurance Median
$278
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: $323 (363%)
Insurance Median: $278 (313%)
Cash: $323 (363% of Medicare)
Ins. Median: $278 (313% 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 313% of the Medicare baseline (a markup of 213%). 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 |
|---|---|---|
| Medicare (plans) | $72 - $104 | 81% |
| Aetna | $81 - $596 | 91% |
| Blue Cross Blue Shield | $81 - $596 | 91% |
| Hospice Mount Carmel | $82 - $99 | 92% |
| Oscar | $82 - $99 | 92% |
| UnitedHealthcare | $82 - $324 | 92% |
| The Health Plan | $84 - $392 | 94% |
| Enterprise Group Planning | $159 - $191 | 179% |
| American Postal Workers Secondary | $172 | 193% |
| Cigna | $172 | 193% |
| Custom Design Benefits | $172 - $207 | 193% |
| Health Partners | $172 | 193% |
| Healthgram | $172 | 193% |
| Mvp | $172 | 193% |
| Priority Health | $172 | 193% |
| Geha | $178 - $324 | 200% |
| Gravie Admin Services | $178 - $268 | 200% |
| Healthez | $178 - $268 | 200% |
| Meritain | $178 - $268 | 200% |
| Webtpa | $178 - $268 | 200% |
| Access Health | $185 - $278 | 208% |
| Acclaim | $185 - $278 | 208% |
| Administrative Concepts | $185 - $278 | 208% |
| Allegeant | $185 - $278 | 208% |
| Allied Benefit Systems | $185 - $278 | 208% |
| American Family | $185 - $278 | 208% |
| American Healthcare Alliance | $185 - $278 | 208% |
| American National | $185 - $278 | 208% |
| American Republic | $185 - $278 | 208% |
| Amerihealth | $185 - $278 | 208% |
| Aultcare | $185 - $278 | 208% |
| Automated Benefit Services | $185 - $278 | 208% |
| Auxiant | $185 - $278 | 208% |
| Benefit Administrative Systems,Llc | $185 - $278 | 208% |
| Boon Chapman | $185 - $278 | 208% |
| Cam Administrative Services | $185 - $278 | 208% |
| Christian Brother Services | $185 - $278 | 208% |
| Christian Brothers Holy Cross | $185 - $278 | 208% |
| Claimchoice Adminstrators | $185 - $278 | 208% |
| Comprehensive Benefits | $185 - $278 | 208% |
| Continental Life Insurance | $185 - $278 | 208% |
| Coventry | $185 - $278 | 208% |
| Custom Benefit Administrators | $185 - $278 | 208% |
| Cypress Benefit Administrators | $185 - $278 | 208% |
| Employee Benefit Concepts | $185 - $278 | 208% |
| Employee Benefit Management | $185 - $278 | 208% |
| Forest County Potawatomi | $185 - $278 | 208% |
| Freedom Life Insurance Company | $185 - $278 | 208% |
| Group Administrators | $185 - $278 | 208% |
| Group Marketing Services | $185 - $278 | 208% |
| Group Pension Administrators | $185 - $278 | 208% |
| Guardian | $185 - $278 | 208% |
| Health America | $185 - $278 | 208% |
| Health Choices | $185 - $278 | 208% |
| Healthcare Management Admin | $185 - $278 | 208% |
| Insight | $185 - $278 | 208% |
| Intercare | $185 - $278 | 208% |
| Jfp Benefit Management | $185 - $278 | 208% |
| Jp Farley Corporation | $185 - $278 | 208% |
| Key Benefit Administrator | $185 - $278 | 208% |
| Liberty Union Life Assurance Co | $185 - $278 | 208% |
| Lucent Health | $185 - $278 | 208% |
| Luminare Health | $185 - $278 | 208% |
| Magnacare | $185 - $278 | 208% |
| Medcost | $185 - $278 | 208% |
| Mutual Health Services | $185 - $278 | 208% |
| Mutual Of Omaha | $185 - $278 | 208% |
| Ncas | $185 - $278 | 208% |
| Nippon Life Ins | $185 - $278 | 208% |
| Nova | $185 - $278 | 208% |
| Painters Union Insurance Fund | $185 - $278 | 208% |
| Physicians Mutual | $185 - $278 | 208% |
| Plumbers Local 98 Insurance Fund | $185 - $278 | 208% |
| Prairie States | $185 - $278 | 208% |
| Preferred One | $185 - $278 | 208% |
| Primary Physician Care | $185 - $278 | 208% |
| Professional Benefit Administrators | $185 - $278 | 208% |
| Secureone Preferred United Plans | $185 - $278 | 208% |
| Siho Insurance Services | $185 - $278 | 208% |
| Sisco Benefits | $185 - $278 | 208% |
| The Loomis Company | $185 - $278 | 208% |
| Trustmark Small Business Benefits | $185 - $278 | 208% |
| U Of M Health Plan | $185 - $278 | 208% |
| Unicare | $185 - $278 | 208% |
| Unified Group Services | $185 - $278 | 208% |
| Us Health And Life | $185 - $278 | 208% |
| Valenz | $185 - $278 | 208% |
| Varipro | $185 - $278 | 208% |
| Wps | $185 - $278 | 208% |
| Quality Care Partners | $186 - $224 | 209% |
| Rural Carrier Health Benefit Plan | $187 - $281 | 210% |
| Humana | $203 - $596 | 228% |
| Medical Mutual | $206 - $454 | 232% |
| First Health | $209 - $314 | 235% |
| Medben | $238 - $447 | 268% |
| Consociate | $243 - $364 | 273% |
| Health Ohio Network | $243 - $364 | 273% |
| Western & Southern Financial Group | $286 - $344 | 322% |
| Caresource | $290 - $435 | 326% |
| Healthlink Inc | $298 - $447 | 335% |
| Medical Benefits Mutual | $298 - $447 | 335% |
| Ohio Health Choice | $298 - $447 | 335% |
| Ohio Ppo Connect | $298 - $447 | 335% |
| Blue Benefit Administrators Of Massachusetts | $313 - $376 | 352% |
| Blue Care Network | $313 - $376 | 352% |
| Blue Distinction Transplant | $313 - $376 | 352% |
| Blue Shield - Ca | $313 - $376 | 352% |
| Blue Shield - Id (Regence) | $313 - $376 | 352% |
| Blue Shield - Ny Highmark Northeastern | $313 - $376 | 352% |
| Blue Shield - Ny Highmark Western | $313 - $376 | 352% |
| Blue Shield - Pa (Highmark) | $313 - $376 | 352% |
| Blue Shield - Wa (Regence) | $313 - $376 | 352% |
| Medi Share | $317 - $476 | 357% |
| Multiplan | $317 - $476 | 357% |
| Phcs | $317 - $476 | 357% |
| Philadelphia American Life Insurance | $317 - $476 | 357% |
| Ameriben | $318 - $477 | 358% |
| Luminare Health (Detroit) | $318 - $477 | 358% |
| Ohiohealthy | $318 - $477 | 358% |
| Osu Not Independent Choice | $318 - $477 | 358% |
| Twin Valley Psychiatric | $318 - $477 | 358% |
| Health Smart | $337 - $507 | 379% |
| Bccp | $397 - $596 | 447% |
| Medicaid / KanCare | $397 - $596 | 447% |
| Optima Health | $397 - $596 | 447% |
| Crime Victim Assistance | $632 | 711% |
| Ohio Safe Program | $632 | 711% |