CMS Price Transparency Data

X-ray, shoulder

Facility: Pawhuska Hospital, Inc

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $217
Cash Discount Price: $158
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Pawhuska Hospital, Inc is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.44x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$217

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: $158 (178%)

Insurance Median: $217 (244%)

Cash: $158 (178% of Medicare)

Ins. Median: $217 (244% 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 244% of the Medicare baseline (a markup of 144%). 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
Blue Cross Blue Shield	$135 - $242	152%
Aetna	$150 - $285	169%
Tricare	$150 - $165	169%
UnitedHealthcare	$150 - $205	169%
Wellcare Mcr Adv - All Plans	$150 - $165	169%
Humana	$152 - $285	171%
Healthcare Highways - All Plans	$168 - $185	189%
Cigna	$176 - $194	198%
Healthchoice Ip/Op Only - All Plans	$180	202%
Multiplan - All Plans	$194 - $214	218%
Community Care Comm - All Plans	$222	250%
Ambetter / Centene	$225 - $248	253%
Preferred Commchoice Ip/Op Only - All Plans	$233 - $256	262%
Soonerselect Mcaid - All Plans	$259 - $285	291%

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 $158.
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 Pawhuska Hospital, Inc 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.