CMS Price Transparency Data

X-ray, shoulder

Facility: Adventist Health Tillamook

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $154
Cash Discount Price: $106
vs. Medicare Baseline: 1.73x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Adventist Health Tillamook is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.73x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$106

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $106 (119%)

Insurance Median: $154 (173%)

Cash: $106 (119% of Medicare)

Ins. Median: $154 (173% 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
Aetna	$9 - $708	10%
Medicare (plans)	$9 - $358	10%
Moda Health Plan - All Plans	$9 - $358	10%
Sterling Life - All Plans	$9 - $372	10%
UnitedHealthcare	$9 - $723	10%
Blue Cross Blue Shield	$10 - $662	11%
Devoted Health	$10 - $386	11%
Hvhs Mcare - All Plans	$11 - $361	12%
Pacificsource - All Plans	$19 - $731	21%
Ods Health Plan - All Other Plans	$20 - $738	22%
Lifewise - All Plans	$56 - $686	63%
Ah Employee Health Plan - All Plans	$58 - $715	65%
First Choice Health- All Plans	$58 - $715	65%
Health Net - All Plans	$58 - $715	65%
Providence Preferred - All Plans	$61 - $746	69%
Workers Comp	$62 - $761	70%
Cigna	$120 - $723	135%
Phcs Preferred - All Plans	$120 - $723	135%

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 $106.
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 Adventist Health Tillamook 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.