CMS Price Transparency Data

X-ray, shoulder

Facility: Adventist Health Portland

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $215
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 2.42x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Adventist Health Portland is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.42x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $187 (210%)
Insurance Median: $215 (242%)
Cash: $187 (210% of Medicare)
Ins. Median: $215 (242% 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 242% of the Medicare baseline (a markup of 142%). 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
Pacific Source Comm - All Plans $27 30%
Ods - All Plans $77 87%
Care Oregon - All Plans $82 92%
Kaiser Mcr Adv $97 109%
Providence Hp - All Plans $98 110%
Humana $99 - $103 111%
Regence Preferred Mcr Adv $102 115%
Moda Mcr Adv $103 116%
UnitedHealthcare $103 - $350 116%
Healthnet Mcr Adv $111 125%
Regence Mcr Adv $130 146%
Healthcare Resources - All Plans $131 147%
Ah Employee Health Plan - All Plans $174 196%
Moda Conn Oebb/Syn Pebb $193 217%
Regence Ohsu Plus $193 217%
Workers Comp $202 227%
Regence - All Other Plans $215 242%
Moda Affinity - All Other Plans $222 250%
Cigna $226 254%
Kaiser - All Other Plans $252 283%
Bc Premera First - All Plans $292 328%
Moda Select $303 341%
Moda Connexus $342 385%
Worldventure - All Plans $350 394%
Moda Synergy $362 407%
First Choice - All Plans $405 456%
Multiplan - All Plans $438 493%
Phcs - All Plans $438 493%
Aetna $457 514%
First Health-Coventry - All Plans $467 525%
National Provider Network - All Plans $514 578%
Health Payors Organization Ltd- All Plans $526 592%
Moda Ohsu Ppo/Epo/Hmc $1,051 1182%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals