CMS Price Transparency Data
X-ray, shoulder
Facility: Mercy Hospital Ardmore, Inc
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $373
- Cash Discount Price: $482
- vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy Hospital Ardmore, Inc is $373. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $482. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.20x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$482
Average discount available for prompt cash payment at this facility.
Insurance Median
$373
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: $482 (542%)
Insurance Median: $373 (420%)
Cash: $482 (542% of Medicare)
Ins. Median: $373 (420% 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 420% of the Medicare baseline (a markup of 320%). 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 |
|---|---|---|
| Aetna | $22 - $565 | 25% |
| Humana | $22 - $613 | 25% |
| Medicaid / KanCare | $22 - $121 | 25% |
| Cigna | $50 - $91 | 56% |
| Administrative Payor Contracted [320005] | $62 | 70% |
| Blue Cross Blue Shield | $88 | 99% |
| Cherokee Nation Health Serv Contracted [320066] | $88 | 99% |
| Cross Timbers Hospice [20098] | $88 | 99% |
| Dept Of Veteran Affairs Contracted [320106] | $88 | 99% |
| Elara Caring Aspire Hospice Contracted [320433] | $88 | 99% |
| Elara Caring Aspire Hospice [20433] | $88 | 99% |
| Halo Hcr Inc Hospice Contracted [320432] | $88 | 99% |
| Halo Hcr Inc Hospice [20432] | $88 | 99% |
| Independent Health [20197] | $88 | 99% |
| Indian Health Service Contracted [320198] | $88 | 99% |
| Kindful Hospice Contracted [320434] | $88 | 99% |
| Kindful Hospice [20434] | $88 | 99% |
| Medical Associates Health [20444] | $88 | 99% |
| Medicare (plans) | $88 - $889 | 99% |
| Mercy Hospice Okc [20252] | $88 | 99% |
| Provider Partners Health Plans Contracted [320450] | $88 | 99% |
| Qual Choice Contracted [320325] | $88 | 99% |
| Tribute Health Plan Mcr Contracted [320338] | $88 | 99% |
| Tricare | $88 | 99% |
| Globalhealth Contracted [320145] | $90 | 101% |
| UnitedHealthcare | $90 - $529 | 101% |
| Ambetter / Centene | $121 | 136% |
| Home State Health Plan Contracted [320187] | $121 | 136% |
| Novasys Contracted [320285] | $121 | 136% |
| Community Care Contracted [320080] | $135 - $622 | 152% |
| Workers Comp [20426] | $152 | 171% |
| Health Choice Contracted [320166] | $198 | 223% |
| Healthsmart Preferred Care Contracted [320184] | $198 - $578 | 223% |
| Kempton Contracted [320214] | $198 | 223% |
| Medica Contracted [320239] | $227 - $889 | 255% |
| Healthcare Highways Plus Contracted [320175] | $231 - $533 | 260% |
| Webtpa Contracted [320417] | $249 - $373 | 280% |
| Osma Health Contracted [320292] | $267 - $400 | 300% |
| United Medical Resources Contracted [320454] | $353 - $578 | 397% |
| Aither Health Contracted [320449] | $356 - $533 | 400% |
| Auxiant Contracted [320462] | $356 - $578 | 400% |
| Benefit Management Contracted [320052] | $356 - $578 | 400% |
| Ebms Contracted [320493] | $356 - $533 | 400% |
| Healthlink Contracted [320179] | $356 - $578 | 400% |
| Imagine 360 Contracted [320494] | $356 - $533 | 400% |
| Mercy Benefit Admin Contracted [320251] | $356 - $578 | 400% |
| Quik Trip Contracted [320447] | $356 - $533 | 400% |
| Reflect Health Contracted [320492] | $356 - $533 | 400% |
| Show-Me Health Administrators Contracted [320483] | $356 - $533 | 400% |
| Yuzu Health Contracted [320521] | $356 - $533 | 400% |
| Federal Medical Center Contracted [320127] | $385 - $578 | 433% |
| Healthscope Contracted [320182] | $385 - $578 | 433% |
| Healthsmart Accel Contracted [320183] | $385 - $578 | 433% |
| Point C Contracted [320238] | $385 - $578 | 433% |
| Preferred Health Plan Contracted [320522] | $385 - $578 | 433% |
| Tri State Healthcare Coalition Contracted [320379] | $385 - $578 | 433% |
| First Health Contracted [320128] | $394 - $591 | 443% |
| Globalhealth Contracted [320144] | $403 - $605 | 453% |
| Private Health Care Systems Contracted [320320] | $445 - $711 | 501% |
| Preferred Community Choice Contracted [320311] | $451 - $676 | 507% |
| Multiplan Contracted [320270] | $474 - $800 | 533% |