CMS Price Transparency Data

X-ray, shoulder

Facility: OHSU Hospital and Clinics

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $134
Cash Discount Price: $521
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at OHSU Hospital and Clinics is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $521. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.51x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.

Cash / Self-Pay

$521

Average discount available for prompt cash payment at this facility.

Insurance Median

$134

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: $521 (586%)

Insurance Median: $134 (151%)

Cash: $521 (586% of Medicare)

Ins. Median: $134 (151% 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.

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
Samaritan Health Plan	$32 - $244	36%
Care Oregon	$78 - $115	88%
Intercommunity Health Network	$78	88%
Kaiser Foundation Hospitals	$78 - $227	88%
Medicare (plans)	$78 - $156	88%
Pacific Source	$78 - $802	88%
Humana	$98 - $104	110%
Trillium	$98	110%
Moda	$103 - $636	116%
UnitedHealthcare	$104 - $398	117%
Aetna	$106 - $131	119%
Community Health Plan Of Washington	$110 - $198	124%
Health Net Health Plan Of Oregon, Inc.	$112 - $799	126%
Providence Health Plan	$116 - $117	130%
Tuality Health	$176	198%
Blue Cross Blue Shield	$297	334%
Cigna	$304	342%
Coventry First Health	$430 - $774	484%
First Choice	$434 - $781	488%
Molina Exchange	$573 - $1,031	644%

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 $521.
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 OHSU Hospital and Clinics 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.