CMS Price Transparency Data

X-ray, shoulder

Facility: Lutheran Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $209
  • Cash Discount Price: $365
  • vs. Medicare Baseline: 2.35x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Lutheran Hospital is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $365. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.35x the Medicare baseline. Located in 1730 West 25Th Street, Cleveland, OH.
Cash / Self-Pay
$365

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: $365 (411%)
Insurance Median: $209 (235%)
Cash: $365 (411% 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
UnitedHealthcare $44 - $348 49%
Paramount $48 54%
Blue Cross Blue Shield $49 - $364 55%
Buckeye $49 55%
Caresource $49 55%
Molina $49 55%
United $49 - $182 55%
United Bh $49 55%
Amerihealth $51 57%
Cigna $52 - $450 58%
Mmo $70 - $337 79%
Aetna $82 - $562 92%
Devoted Health $82 92%
Humana $82 - $478 92%
Summacare $82 - $227 92%
The Health Plan $82 - $337 92%
Upmc $82 - $337 92%
Valor $82 92%
Communicare $86 97%
Perennial Health $88 99%
Pphp $90 101%
Zing Health $90 101%
Oscar $169 - $216 190%
Cc Ehp $224 - $228 252%
Aultcare $242 272%
Amish Community Aid Plan $253 - $281 285%
Ohcp $273 307%
Omas $281 316%
Ohio Healthy $303 341%
Healthsmart $309 348%
Php $337 379%
Phphi $337 379%
Gms $393 442%
Medical Benefit Corp $393 442%
Quality Care Partners $393 442%
Consociate Health $422 475%
Frontpath $506 569%
Managed Care Services $506 569%
Multiplan $506 569%
Tertiary Care Network $506 569%
Three Rivers $506 569%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1730 West 25Th Street, Cleveland, OH 44113
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals