CMS Price Transparency Data

X-ray, shoulder

Facility: The Heart Hospital Baylor Denton

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $260
Cash Discount Price: $284
vs. Medicare Baseline: 2.92x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at The Heart Hospital Baylor Denton is $260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $284. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.92x the Medicare baseline. Located in 2801 South Mayhill Road, Denton, TX.

Cash / Self-Pay

$284

Average discount available for prompt cash payment at this facility.

Insurance Median

$260

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: $284 (319%)

Insurance Median: $260 (292%)

Cash: $284 (319% of Medicare)

Ins. Median: $260 (292% 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 292% of the Medicare baseline (a markup of 192%). 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
Superior Health Plan	$35 - $88	39%
Baylor Scott & White Health Plan	$79 - $275	89%
Humana	$83 - $332	93%
Triwest	$83	93%
Corvel	$87	98%
Prime Health Services	$87	98%
American Health Plan	$88	99%
Blue Cross Blue Shield	$88 - $319	99%
Healthspring	$88	99%
Procare Advantage	$88	99%
UnitedHealthcare	$96 - $327	108%
Ambetter / Centene	$173	195%
Cigna	$233 - $275	262%
Aetna	$260	292%
Employers Health Network	$260	292%
Quiktrip	$260	292%
Imagine Health	$271	305%
University Of Mary Hardin-Baylor	$275	309%
Curative	$308	346%
First Health	$332	373%
Healthsmart	$332 - $355	373%
Private Health Care System	$355	399%

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 $284.
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 The Heart Hospital Baylor Denton 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.