CMS Price Transparency Data

X-ray, shoulder

Facility: Primary Children's Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $195
  • Cash Discount Price: $206
  • vs. Medicare Baseline: 2.19x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Primary Children's Hospital is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.19x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$206

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $206 (232%)
Insurance Median: $195 (219%)
Cash: $206 (232% of Medicare)
Ins. Median: $195 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
American Health $9 - $156 10%
Health Plan Of Nevada $9 - $43 10%
Healthy U $9 - $51 10%
Molina $9 - $231 10%
Selecthealth $9 - $231 10%
Southwest Behavioral Health $9 - $83 10%
UnitedHealthcare $9 - $231 10%
Tricare $84 94%
Triwest $84 94%
Donor Connect $99 - $109 111%
Aetna $195 - $233 219%
Awh Connected $195 - $233 219%
Byu Athletics $195 - $231 219%
Campbell Scientific $195 - $231 219%
Cigna $195 - $231 219%
Deseret Mutual $195 - $231 219%
Emi $195 - $231 219%
Emi Health $195 - $231 219%
First Choice $195 - $231 219%
First Choice Of The Midwest $195 - $231 219%
Franklin County $195 - $231 219%
Global Excel $195 - $231 219%
Health Utah $195 - $231 219%
Humana $195 - $231 219%
Hygeia Corporation $195 - $231 219%
Ifit $195 - $231 219%
Juniper Systems $195 - $231 219%
Lw Miller $195 - $231 219%
Managed Care Admin $195 - $231 219%
Medcare International $195 - $231 219%
Motivhealth $195 - $231 219%
Pehp $195 - $231 219%
Prodegi Corp Benefit $195 - $231 219%
Tanner Llc $195 - $231 219%
Uofu $195 - $231 219%
Utah Tech $195 - $231 219%
Wise Network $195 - $231 219%
First Health $198 - $233 223%
Blue Cross Blue Shield $200 - $236 225%
Springtide $200 - $236 225%
Utah Behavioral Health Network $222 250%
Altius Mhnet Behavioral Health $242 272%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens