CMS Price Transparency Data

X-ray, shoulder

Facility: Guadalupe Regional Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $87
Cash Discount Price: $92
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Guadalupe Regional Medical Center is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.98x the Medicare baseline. Located in 1215 E Court St, Seguin, TX.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $92 (103%)

Insurance Median: $87 (98%)

Cash: $92 (103% of Medicare)

Ins. Median: $87 (98% 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
Superior Hlth Plan Mmcd	$20 - $151	22%
Aetna	$32 - $286	36%
Christus Exchange Health Plan	$32 - $87	36%
Mcr Clover Health	$32 - $87	36%
Mcr Texas Independence Health	$32 - $87	36%
Mcr Wellcare	$32 - $87	36%
Oscar Health Plan	$32 - $87	36%
Va Triwest Health Alliance	$32 - $87	36%
Healthcare Highways	$33 - $252	37%
UnitedHealthcare	$33 - $252	37%
Humana	$37 - $286	42%
Cigna	$40 - $302	45%
Texas Mutual Insurance Co	$40 - $302	45%
Blue Cross Blue Shield	$186 - $207	209%

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 $92.
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 Guadalupe Regional 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.