CMS Price Transparency Data

X-ray, shoulder

Facility: Hillcrest Hospital Claremore

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $1,187
Cash Discount Price: $837
vs. Medicare Baseline: 13.35x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Hillcrest Hospital Claremore is $1,187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $837. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 13.35x the Medicare baseline. Located in 1202 N Muskogee Place, Claremore, OK.

Cash / Self-Pay

$837

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,187

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: $837 (941%)

Insurance Median: $1,187 (1335%)

Cash: $837 (941% of Medicare)

Ins. Median: $1,187 (1335% 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 1335% of the Medicare baseline (a markup of 1235%). 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]	$558 - $837	628%
Healthcare Highways [2210]	$558 - $1,320	628%
Hooray Health [8000]	$558 - $837	628%
Lucent Health [6000]	$558 - $837	628%
Oncology Patient Assistance Programs [2295]	$558 - $837	628%
Oscar Insurance Company [7005]	$558 - $837	628%
Osma Health Network [2345]	$558 - $837	628%
Healthscope Benefits [2290]	$671 - $1,006	755%
UnitedHealthcare	$671 - $1,314	755%
Resource One Administrators [2815]	$880 - $1,320	990%
Web Tpa [2115]	$880 - $1,470	990%
Beacon Health Options Behavioral Health [2890]	$960 - $1,440	1080%
Aetna	$980 - $1,470	1102%
The Kempton Group Administrators [2905]	$1,005 - $1,507	1130%
Pba [1775]	$1,112 - $1,668	1251%
Medica [2910]	$1,262 - $1,892	1419%
Employee Benefit Management Services [2445]	$1,630 - $2,445	1833%
Healthcost Solutions [2415]	$1,742 - $2,613	1959%
Healthfirst [2395]	$1,742 - $2,613	1959%
Hometown Health [2155]	$1,742 - $2,613	1959%
Mayo Clinic Health Solutions [2280]	$1,742 - $2,613	1959%
Planned Administrators Inc [2360]	$1,742 - $2,613	1959%
Trustmark [2030]	$1,742 - $2,613	1959%
Universal Fidelity [2085]	$1,742 - $2,613	1959%

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 $837.
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 Claremore 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.