CMS Price Transparency Data

X-ray, shoulder

Facility: Licking Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $722
  • Cash Discount Price: $1,059
  • vs. Medicare Baseline: 8.12x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Licking Memorial Hospital is $722. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,059. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 8.12x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$1,059

Average discount available for prompt cash payment at this facility.

Insurance Median
$722

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: $1,059 (1191%)
Insurance Median: $722 (812%)
Cash: $1,059 (1191% of Medicare)
Ins. Median: $722 (812% 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 812% of the Medicare baseline (a markup of 712%). 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
Tricare $82 92%
Aetna $84 - $1,325 94%
Blue Cross Blue Shield $84 - $1,378 94%
Champva [500001] $84 94%
Cigna $84 - $1,443 94%
Humana $84 - $1,556 94%
Medicare (plans) $84 94%
UnitedHealthcare $84 - $1,363 94%
Veterans Administration [100068] $84 94%
Wellcare By Allwell [450104] $84 94%
Molina Marketplace [100106] $134 151%
Medical Mutual [100114] $362 - $1,331 407%
Medben [700068] $461 - $1,572 519%
Benicomp [70090] $493 - $1,203 554%
Consociate Health 6 Degrees [100059] $526 - $1,283 592%
Consociate Health [100029] $526 - $1,283 592%
Allied Benefit Systems [100015] $538 - $1,312 605%
Geha [100039] $538 - $1,312 605%
Gravie Administrative Services [100165] $538 - $1,312 605%
Meritain [100063] $538 - $1,312 605%
Optima [700069] $538 - $1,312 605%
Trustmark Small Business Benefits [100263] $538 - $1,312 605%
Webtpa [100127] $538 - $1,312 605%
Healthscope [100157] $559 - $1,363 629%
Surest [100016] $559 - $1,363 629%
United Medical Resources [700071] $559 - $1,363 629%
American Postal Workers [100089] $592 - $1,443 666%
Antidote Health Plan Of Ohio [70006803] $592 - $1,443 666%
Coresource [100002] $592 - $1,604 666%
Great West Life [700064] $592 - $1,443 666%
National Association Of Letter Carriers [100067] $592 - $1,443 666%
Ohio Healthy Luminare Health [100264] $592 - $1,443 666%
Ohio Healthy [100255] $592 - $1,443 666%
Ohio Ppo Connect [70006801] $592 - $1,443 666%
Osu Prime Care [100254] $592 - $1,443 666%
Quality Care Partners [70006802] $592 - $1,443 666%
The Health Plan [100261] $592 - $1,443 666%
Wellfleet Group, Llc [100164] $592 - $1,443 666%
Coventry [100010] $607 - $1,480 683%
Pan American Life [700070] $607 - $1,480 683%
Ohio Health Choice [100109] $632 - $1,540 711%
Administrative Concepts [100006] $638 - $1,556 718%
Carefactor [100087] $638 - $1,556 718%
Philadelphia American Life [100260] $638 - $1,604 718%
Reliance Standard-Asrm [100258] $638 - $1,556 718%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals