CMS Price Transparency Data

X-ray, shoulder

Facility: Texas Orthopedic Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $539
  • Cash Discount Price: $2,771
  • vs. Medicare Baseline: 6.06x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Texas Orthopedic Hospital is $539. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,771. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.06x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$2,771

Average discount available for prompt cash payment at this facility.

Insurance Median
$539

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: $2,771 (3117%)
Insurance Median: $539 (606%)
Cash: $2,771 (3117% of Medicare)
Ins. Median: $539 (606% 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 606% of the Medicare baseline (a markup of 506%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Texas Health Network $34 38%
Amerigroup $35 39%
Community Health Choice Mcd $35 39%
Texas Childrens Health Plans $35 - $633 39%
United $35 - $1,715 39%
Aetna $38 - $162 43%
Molina Healthcare $39 44%
Humana $44 - $347 49%
Cigna $93 - $120 105%
Superior Health Plan $104 - $229 117%
Blue Cross Blue Shield $140 - $1,334 157%
Texas Workforce Commission $415 - $915 467%
Healthcare Highways $441 - $972 496%
Evry Health $472 - $1,041 531%
Imagine Health $606 - $1,334 682%
Christus (Usfhp) $692 - $1,525 778%
Curative Administrators $692 - $1,525 778%
Healthsmart Preferred Care $744 - $3,240 837%
Averde Health $779 - $1,715 876%
Fidelis Securecare Of Tx $779 - $1,715 876%
Coventry National First Health $922 - $2,032 1037%
Physicians Cooperative Of Texas $952 - $2,096 1071%
Rockport Workers Comp $952 - $2,096 1071%
Independent Medical System $1,038 - $2,287 1167%
National Healthcare Solutions $1,038 - $2,287 1167%
Southwest Medical $1,038 - $2,287 1167%
Coastal Comp $1,125 - $2,478 1265%
Multiplan $1,298 - $3,240 1460%
International Health Insurance $1,384 - $3,049 1557%
Physicians, Inc $1,471 - $3,240 1654%
Affiliated Ppo $1,557 - $3,431 1751%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals