CMS Price Transparency Data

X-ray, shoulder

Facility: Hillcrest Hospital Pryor

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $395
Cash Discount Price: $228
vs. Medicare Baseline: 4.44x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Hillcrest Hospital Pryor is $395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.44x the Medicare baseline. Located in 111 North Bailey Street, Pryor, OK.

Cash / Self-Pay

$228

Average discount available for prompt cash payment at this facility.

Insurance Median

$395

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: $228 (256%)

Insurance Median: $395 (444%)

Cash: $228 (256% of Medicare)

Ins. Median: $395 (444% 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 444% of the Medicare baseline (a markup of 344%). 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
Black Lung [6055]	$152 - $228	171%
Healthcare Highways [2210]	$152 - $592	171%
Hooray Health [8000]	$152 - $228	171%
Lucent Health [6000]	$152 - $228	171%
Oncology Patient Assistance Programs [2295]	$152 - $228	171%
Oscar Insurance Company [7005]	$152 - $228	171%
Osma Health Network [2345]	$152 - $228	171%
Healthscope Benefits [2290]	$186 - $279	209%
UnitedHealthcare	$186 - $279	209%
Aetna	$266 - $400	299%
Allied Benefit Systems Inc [1030]	$266 - $400	299%
Coresource [1315]	$266 - $400	299%
Coventry Healthcare [1320]	$266 - $400	299%
Meritain Health [1655]	$266 - $400	299%
The Kempton Group Administrators [2905]	$273 - $410	307%
Beacon Health Options Behavioral Health [2890]	$376 - $565	423%
Global Health [1430]	$376 - $565	423%
Resource One Administrators [2815]	$395 - $592	444%
Universal Fidelity [2085]	$395 - $592	444%
Web Tpa [2115]	$395 - $592	444%
First Health [1375]	$448 - $672	504%
Medica [2910]	$448 - $672	504%
Multiplan [1680]	$448 - $672	504%
Cigna	$500 - $749	562%
Healthpartners [1500]	$500 - $749	562%
Pba [1775]	$500 - $749	562%
Pending Ssi [1616]	$607 - $910	683%

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 $228.
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 Hillcrest Hospital Pryor 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.