CMS Price Transparency Data

X-ray, shoulder

Facility: Tristar Horizon Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $129
Cash Discount Price: $1,155
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Tristar Horizon Medical Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,155. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.45x the Medicare baseline. Located in 111 Highway 70 East, Dickson, TN.

Cash / Self-Pay

$1,155

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $1,155 (1299%)

Insurance Median: $129 (145%)

Cash: $1,155 (1299% of Medicare)

Ins. Median: $129 (145% 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
Blue Cross Blue Shield	$19 - $43	21%
Humana	$35 - $289	39%
Aetna	$46 - $578	52%
Cigna	$82 - $924	92%
United	$84 - $520	94%
Kentucky Labor Cabinet	$213	240%
Apex Health	$219	246%
Nhc Advantage, Inc.	$219	246%
Pruitt Health (Allyalign)	$219	246%
Centurion	$476	535%
Bgfh Singlesource	$578 - $982	650%
Employers Health Network	$808	909%
Odom'S Tn Pride Sausage	$866	974%
Multiplan	$1,040	1170%
Beech Street	$1,063	1196%

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 $1,155.
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 Tristar Horizon Medical Center 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.