CMS Price Transparency Data

X-ray, shoulder

Facility: Northwest Texas Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $246
Cash Discount Price: $168
vs. Medicare Baseline: 2.77x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Northwest Texas Hospital is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.77x the Medicare baseline. Located in 1501 S Coulter St, Amarillo, TX.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$246

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: $168 (189%)

Insurance Median: $246 (277%)

Cash: $168 (189% of Medicare)

Ins. Median: $246 (277% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 277% of the Medicare baseline (a markup of 177%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Molina	$7	8%
First_Care_Star	$28	31%
First_Carestar	$28	31%
Superior	$28	31%
United_Healthcare	$79 - $444	89%
Cigna	$82	92%
Aetna	$90 - $506	101%
Amerigroup	$102	115%
Scott_And_White_Healthplan	$110 - $621	124%
Health_Smart	$245 - $1,382	276%
Multiplan	$326 - $1,839	367%
Scott_And_White _Healthplan	$414 - $621	466%

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 $168.
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 Northwest Texas Hospital 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.