CMS Price Transparency Data

X-ray, shoulder

Facility: HCA Houston Healthcare Tomball

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $201
Cash Discount Price: $2,320
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at HCA Houston Healthcare Tomball is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,320. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.26x the Medicare baseline. Located in 605 Holderrieth, Tomball, TX.

Cash / Self-Pay

$2,320

Average discount available for prompt cash payment at this facility.

Insurance Median

$201

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: $2,320 (2609%)

Insurance Median: $201 (226%)

Cash: $2,320 (2609% of Medicare)

Ins. Median: $201 (226% 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 226% of the Medicare baseline (a markup of 126%). 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
Community Health Choice Mcd	$35	39%
Texas Childrens Healthplans	$35	39%
United	$35 - $1,047	39%
Aetna	$38 - $271	43%
Molina Healthcare	$39	44%
Humana	$44 - $347	49%
Cigna	$93 - $120	105%
Superior Health Plan	$139 - $140	156%
Blue Cross Blue Shield	$140 - $814	157%
Healthcare Highways	$590 - $593	664%
Evry Health	$632 - $635	711%
Coventry National First Health	$842 - $847	947%
Christus (Usfhp)	$926 - $931	1042%
Curative Administrators	$926 - $931	1042%

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 $2,320.
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 HCA Houston Healthcare Tomball 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.