CMS Price Transparency Data

X-ray, shoulder

Facility: South Pointe Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $208
Cash Discount Price: $365
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at South Pointe Hospital is $208. 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 2.34x the Medicare baseline. Located in 20000 Harvard Road, Warrensville Heights, OH.

Cash / Self-Pay

$365

Average discount available for prompt cash payment at this facility.

Insurance Median

$208

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: $208 (234%)

Cash: $365 (411% of Medicare)

Ins. Median: $208 (234% 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 234% of the Medicare baseline (a markup of 134%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$51 - $348	57%
Cigna	$52 - $450	58%
Paramount	$56	63%
Blue Cross Blue Shield	$57 - $364	64%
Buckeye	$57	64%
Molina	$57	64%
Caresource	$58	65%
United	$58 - $182	65%
Amerihealth	$59	66%
Mmo	$70 - $337	79%
Aetna	$82 - $562	92%
Devoted Health	$82	92%
Humana	$82 - $478	92%
Summacare	$82 - $210	92%
The Health Plan	$82 - $337	92%
Upmc	$82 - $337	92%
Valor	$82	92%
Communicare	$86	97%
Perennial Health	$88	99%
Pphp	$90	101%
Oscar	$169 - $216	190%
Cc Ehp	$224 - $228	252%
Aultcare	$242	272%
Ohcp	$273	307%
Omas	$281	316%
Ohio Healthy	$303	341%
Healthsmart	$309	348%
Php	$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

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $365.
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 South Pointe 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.