CMS Price Transparency Data

X-ray, shoulder

Facility: Prisma Health Oconee Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $93
  • Cash Discount Price: $387
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Prisma Health Oconee Memorial Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $387. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.05x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$387

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $387 (435%)
Insurance Median: $93 (105%)
Cash: $387 (435% of Medicare)
Ins. Median: $93 (105% 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.

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
First Choice Benefits Mgmt [3074] $43 48%
Medicaid / KanCare $43 - $92 48%
Medicare (plans) $43 - $97 48%
Humana $46 - $92 52%
Blue Cross Blue Shield $63 - $169 71%
Sc Dept Of Corrections [2998] $63 71%
Scdc-Sc Dept Of Corrections [7232] $63 71%
Tricare $87 98%
Champva [3049] $89 100%
Cigna $89 - $443 100%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $89 100%
Deseret Mutual Ins Co [3066] $89 100%
Generic Skilled Nursing [3196] $89 100%
Hospice Contracted [1500] $89 100%
Hospice Non Contracted [3190] $89 100%
Triwest Healthcare Alliance Vcp [902] $89 100%
Va Community Care Network-Vaccn [903] $89 100%
Veterans Administration [3194] $89 100%
UnitedHealthcare $92 - $422 103%
Aetna $93 - $470 105%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $93 105%
Healthy Conn Prime-First Choice Vip Care [5300] $94 106%
Bluechoice [810] $96 - $229 108%
Healthy Conn Prime-Molina Healthcare [5330] $97 109%
Workers Comp [600] $124 139%
Prisma Health Seniorcare Pace - Midlands [5400] $138 155%
Prisma Health Seniorcare Pace-Upstate [5200] $138 155%
Bob Jones Univ-Pai [821] $158 178%
Ambetter / Centene $163 183%
Planned Administrators [820] $169 190%
Promise Health Plan Contracted [2401] $208 - $357 234%
Orangeburg Senior Helping Center Pace [5401] $238 268%
Meritain Health Contracted [2200] $381 - $470 429%
Preferred Administrators Contracted [2839] $416 468%
Golden Rule Insurance Company [2991] $422 475%
Oxford Health Plans [2992] $422 475%
Zzumr-Salt Lake City Ut [3169] $422 475%
Medcost [2940] $440 - $494 495%
Evernorth Behavioral Contracted [2982] $443 498%
Mvp Health Care [3037] $443 498%
Atlantic Packaging Contracted [4833] $446 502%
Aps Healthcare System [2981] $476 535%
Multiplan/Phcs Contracted [2950] $530 596%
Vsp Vision Care [2986] $536 603%
First Health Contracted [2952] $553 622%
Furman Int/Allen University Student [2951] $553 622%
Quiktrip-First Health [3067] $553 622%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 298 Memorial Dr, Seneca, SC 29672
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals