CMS Price Transparency Data

X-ray, shoulder

Facility: Highland District Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $98
Cash Discount Price: $234
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Highland District Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.10x the Medicare baseline. Located in 1275 North High Street, Hillsboro, OH.

Cash / Self-Pay

$234

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $234 (263%)

Insurance Median: $98 (110%)

Cash: $234 (263% of Medicare)

Ins. Median: $98 (110% 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
Highland_County_Sheriff_Dept	$35	39%
Medicaid / KanCare	$35 - $37	39%
Blue Cross Blue Shield	$36 - $223	40%
Humana	$36 - $260	40%
Medicare (plans)	$94 - $97	106%
UnitedHealthcare	$94	106%
Aetna	$96 - $238	108%
Medigold	$98	110%
Immergrun_Amish	$234	263%
Medben	$234	263%
Central_Benefits_Commercial	$264	297%
Cigna	$264	297%
Medical_Mutual_Commercial	$267	300%
Uhc_	$270	304%

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 $234.
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 Highland District 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.