CMS Price Transparency Data

X-ray, shoulder

Facility: Dell Children's Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $193
Cash Discount Price: $474
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Dell Children's Medical Center is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $474. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.17x the Medicare baseline. Located in 4900 Mueller Blvd, Austin, TX.

Cash / Self-Pay

$474

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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: $474 (533%)

Insurance Median: $193 (217%)

Cash: $474 (533% of Medicare)

Ins. Median: $193 (217% 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 217% of the Medicare baseline (a markup of 117%). 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
Champva	$20 - $28	22%
Ambetter / Centene	$27 - $35	30%
Blue Cross Blue Shield	$27 - $323	30%
Dell Chip/Chip Perinate	$27 - $28	30%
Dell Star	$27 - $28	30%
UnitedHealthcare	$27 - $28	30%
Wellpoint Chip/Chip Perinate	$27 - $35	30%
Wellpoint Star	$27 - $28	30%
Wellpoint Star Plus	$27 - $35	30%
Wellpoint Star Kids	$35	39%
Humana	$44	49%
Tricare	$59	66%
Aetna	$118 - $241	133%
Superior Star	$160 - $408	180%
Superior Star Foster	$160 - $408	180%
Superior Star Kids	$160 - $408	180%
Superior Star Plus	$160 - $408	180%
Superior Chip/Chip Perinate	$179 - $459	201%
Cigna	$194	218%
Covenant Health	$241	271%
Seton Performance Plus	$251	282%

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 $474.
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 Dell Children's 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.