CMS Price Transparency Data

X-ray, shoulder

Facility: Nationwide Children's Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $282
Cash Discount Price: $270
vs. Medicare Baseline: 3.17x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Nationwide Children's Hospital is $282. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.17x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$270

Average discount available for prompt cash payment at this facility.

Insurance Median

$282

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: $270 (304%)

Insurance Median: $282 (317%)

Cash: $270 (304% of Medicare)

Ins. Median: $282 (317% 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 317% of the Medicare baseline (a markup of 217%). 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
Aetna	$10 - $504	11%
Caresource	$13 - $133	15%
Humana	$21 - $504	24%
UnitedHealthcare	$25 - $504	28%
Ohio Ppo Connect	$26 - $493	29%
Osu	$26 - $493	29%
Blue Cross Blue Shield	$28 - $498	31%
Mmo	$32 - $498	36%
Tricare	$32	36%
Cigna	$34 - $498	38%
Front Path Health Coalition	$34 - $498	38%
Ohc	$34 - $493	38%
Ohg	$34 - $477	38%
The Health Plan	$34 - $509	38%
Amerihealth	$87	98%
Bchp	$87	98%
Molina	$87	98%
Ahpo	$282 - $498	317%
Unicare	$285 - $504	321%
Emerald Health	$294 - $519	331%
First Health	$294 - $519	331%
Phcs	$294 - $519	331%

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 $270.
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 Nationwide Children's 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.