CMS Price Transparency Data

X-ray, shoulder

Facility: Reston Hospital Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $553
Cash Discount Price: $1,287
vs. Medicare Baseline: 6.22x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Reston Hospital Center is $553. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,287. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.22x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$1,287

Average discount available for prompt cash payment at this facility.

Insurance Median

$553

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: $1,287 (1448%)

Insurance Median: $553 (622%)

Cash: $1,287 (1448% of Medicare)

Ins. Median: $553 (622% 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 622% of the Medicare baseline (a markup of 522%). 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
Blue Cross Blue Shield	$34 - $152	38%
Carefirst	$145	163%
Cigna	$149 - $157	168%
United	$182 - $1,157	205%
Lifeworks	$233 - $489	262%
Universal Healthcare Group	$270 - $566	304%
Greenvbrier Sporting Club	$737 - $1,543	829%
Virginia Health Network	$872 - $1,826	981%
Corvel	$885 - $1,852	995%
Occunet Workers Comp	$983 - $2,057	1106%
4Most Health Network	$1,106 - $2,315	1244%

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 $1,287.
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 Reston Hospital 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.