CMS Price Transparency Data
X-ray, shoulder
Facility: St Charles Madras
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $80
- Cash Discount Price: $209
- vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at St Charles Madras is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $209. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.90x the Medicare baseline. Located in 470 Ne A Street, Madras, OR.
Cash / Self-Pay
$209
Average discount available for prompt cash payment at this facility.
Insurance Median
$80
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: $209 (235%)
Insurance Median: $80 (90%)
Cash: $209 (235% of Medicare)
Ins. Median: $80 (90% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $28 - $168 | 31% |
| Medicare (plans) | $28 - $114 | 31% |
| Blue Cross Blue Shield | $29 - $311 | 33% |
| Aetna | $30 - $356 | 34% |
| Ageright Advantage [142] | $30 - $98 | 34% |
| Champ Va [700] | $30 - $98 | 34% |
| Cigna | $30 - $258 | 34% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $30 - $98 | 34% |
| Devoted Health Inc [145] | $30 - $98 | 34% |
| Health Market Care Assured [134] | $30 - $98 | 34% |
| Health Net Med Adv [135] | $30 - $98 | 34% |
| Humana | $30 - $98 | 34% |
| Indian Health [704] | $30 - $98 | 34% |
| Kaiser Permanente Med Adv [136] | $30 - $98 | 34% |
| Law Enforcement [701] | $30 - $203 | 34% |
| Samaritan Health Plan Med Adv [141] | $30 - $98 | 34% |
| Unicare [133] | $30 - $98 | 34% |
| UnitedHealthcare | $30 - $378 | 34% |
| Veterans [706] | $30 - $98 | 34% |
| Wellcare [132] | $30 - $98 | 34% |
| Tricare | $33 - $128 | 37% |
| Advanced Health [534] | $47 - $168 | 53% |
| Allcare Health Plan [538] | $47 - $168 | 53% |
| Cascade Health Alliance [532] | $47 - $168 | 53% |
| Columbia Pacific Coordinated Care Llc [539] | $47 - $168 | 53% |
| Health Share Care Oregon [526] | $47 - $168 | 53% |
| Health Share Kaiser [543] | $47 - $168 | 53% |
| Health Share Ohsu Ohp [552] | $47 - $168 | 53% |
| Health Share Providence [548] | $47 - $168 | 53% |
| Health Share [537] | $47 - $168 | 53% |
| Intercommunity Health [530] | $47 - $168 | 53% |
| Jackson Care Connect [542] | $47 - $168 | 53% |
| Primary Health Of Jospehine County Llc [547] | $47 - $168 | 53% |
| Umpqua Health [533] | $47 - $168 | 53% |
| Willamette Valley Community Health [536] | $47 - $168 | 53% |
| Yamhill County Coordinated Care Org [550] | $47 - $168 | 53% |
| Auto Allstate Insurance [602] | $59 - $80 | 66% |
| Auto American Family Insurance [603] | $59 - $80 | 66% |
| Auto Country Insurance Claims [604] | $59 - $80 | 66% |
| Auto Dairyland Insurance [617] | $59 - $80 | 66% |
| Auto Farmers [605] | $59 - $80 | 66% |
| Auto Geico Claims Oregon [606] | $59 - $80 | 66% |
| Auto Hartford [612] | $59 - $80 | 66% |
| Auto Liberty Mutual Auto Ins [613] | $59 - $80 | 66% |
| Auto Mutual Of Enumclaw [610] | $59 - $80 | 66% |
| Auto Nationwide Allied Insuranc [601] | $59 - $80 | 66% |
| Auto Oregon Mutual [614] | $59 - $80 | 66% |
| Auto Progressive [608] | $59 - $80 | 66% |
| Auto Safeco Concentra [600] | $59 - $80 | 66% |
| Auto State Farm Claims [609] | $59 - $80 | 66% |
| Auto Sublimity Insurance [616] | $59 - $80 | 66% |
| Auto Travelers Insurance [615] | $59 - $80 | 66% |
| Auto Usaa [611] | $59 - $80 | 66% |
| Generic Auto [649] | $59 - $80 | 66% |
| Generic Workers Comp [699] | $59 - $80 | 66% |
| Otj Broadspire Services [670] | $59 - $80 | 66% |
| Otj Ccmsi [618] | $59 - $80 | 66% |
| Otj Chartis Claims [650] | $59 - $80 | 66% |
| Otj City County Ins Services [662] | $59 - $80 | 66% |
| Otj Corvel [676] | $59 - $80 | 66% |
| Otj Esis West Wc Claims [653] | $59 - $80 | 66% |
| Otj Gallagher Bassett [654] | $59 - $80 | 66% |
| Otj Hartford [655] | $59 - $80 | 66% |
| Otj Intermountain Claims Inc [666] | $59 - $80 | 66% |
| Otj Liberty Mutual Wausau Underwriters [671] | $59 - $80 | 66% |
| Otj Penser No American [663] | $59 - $80 | 66% |
| Otj Pinnacle Risk Mgmt [661] | $59 - $80 | 66% |
| Otj Saif [667] | $59 - $80 | 66% |
| Otj Sedgwick Cms [660] | $59 - $80 | 66% |
| Otj Sedgwick [668] | $59 - $80 | 66% |
| Otj Travelers Insurance [672] | $59 - $80 | 66% |
| Otj Tristar [673] | $59 - $80 | 66% |
| Pacificsource [345] | $65 - $224 | 73% |
| Us Benefits [326] | $72 - $258 | 81% |
| Providence Health Plan [347] | $80 - $358 | 90% |
| Pacificsource Community Solutions [525] | $86 - $95 | 97% |
| Rocky Mountain Administrators [405] | $91 - $327 | 102% |
| Rx Internal [4100003] | $93 - $334 | 105% |
| Moda [310] | $98 - $352 | 110% |
| First Choice Health [317] | $99 - $354 | 111% |
| Kaiser Permanente [334] | $99 - $354 | 111% |
| Meritain Health [300] | $99 - $356 | 111% |
| Samaritan [376] | $99 - $354 | 111% |
| Health Net [340] | $107 - $384 | 120% |
| Administrative Concepts Inc [402] | $112 - $401 | 126% |
| First Health [339] | $112 - $401 | 126% |
| Manhattan Life Insurance Company [379] | $112 - $401 | 126% |
| Philadelphia American Life Insurance Company [395] | $112 - $401 | 126% |
| Planned Administrators Inc [375] | $112 - $401 | 126% |
| Otj Dept Of Labor Federal Emp [652] | $130 | 146% |
| Otj Us Department Of Labor [669] | $130 | 146% |
| Bridgespan [342] | $264 | 297% |
| Asuris Northwest Health [202] | $311 | 350% |
| Healthcare Management Admin [201] | $311 | 350% |
| Regence Group Administrators [203] | $311 | 350% |