CMS Price Transparency Data

X-ray, shoulder

Facility: Prisma Health Tuomey Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $103
  • Cash Discount Price: $387
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Prisma Health Tuomey Hospital is $103. 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 1.16x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$387

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $103 (116%)
Cash: $387 (435% of Medicare)
Ins. Median: $103 (116% 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
Medicaid / KanCare $37 - $92 42%
Humana $40 - $446 45%
Blue Cross Blue Shield $59 - $266 66%
Bluechoice [810] $59 - $265 66%
Scdc-Sc Dept Of Corrections [7232] $63 71%
Cigna $81 - $443 91%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $81 91%
Medicare (plans) $81 - $85 91%
Triwest Healthcare Alliance Vcp [902] $81 91%
Va Community Care Network-Vaccn [903] $81 91%
Tricare $82 92%
UnitedHealthcare $84 - $195 94%
Aetna $85 - $470 96%
Healthy Conn Prime-First Choice Vip Care [5300] $85 96%
Healthy Conn Prime-Molina Healthcare [5330] $85 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $85 96%
Workers Comp [600] $114 128%
Prisma Health Seniorcare Pace - Midlands [5400] $138 155%
Prisma Health Seniorcare Pace-Upstate [5200] $138 155%
Ambetter / Centene $150 169%
Bob Jones Univ-Pai [821] $158 178%
Golden Rule Insurance Company [2991] $195 219%
Oxford Health Plans [2992] $195 219%
Zzumr-Salt Lake City Ut [3169] $195 219%
Promise Health Plan Contracted [2401] $208 - $357 234%
Orangeburg Senior Helping Center Pace [5401] $238 268%
Planned Administrators [820] $266 299%
Meritain Health Contracted [2200] $381 - $470 429%
Preferred Administrators Contracted [2839] $416 468%
Medcost [2940] $440 - $494 495%
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: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals