CMS Price Transparency Data

X-ray, shoulder

Facility: Carilion Tazewell Community Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $348
Cash Discount Price: $221
vs. Medicare Baseline: 3.91x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Carilion Tazewell Community Hospital is $348. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $221. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.91x the Medicare baseline. Located in 388 Ben Bolt Avenue, Tazewell, VA.

Cash / Self-Pay

$221

Average discount available for prompt cash payment at this facility.

Insurance Median

$348

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: $221 (249%)

Insurance Median: $348 (391%)

Cash: $221 (249% of Medicare)

Ins. Median: $348 (391% 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 391% of the Medicare baseline (a markup of 291%). 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
Corvel	$28	31%
Blue Cross Blue Shield	$31 - $459	35%
Sentara Health Plan	$32 - $392	36%
Abh Of Va (Formerly Coventry)	$33	37%
Abh Of Wva (Formerly Coventry)	$33	37%
Humana	$33 - $83	37%
UnitedHealthcare	$33 - $517	37%
Aetna	$76 - $420	85%
Allcare	$81	91%
Gateway - Tier 3	$348	391%
Vhn - Ultra	$392	441%
Cigna	$401 - $428	451%
Connecticare	$442	497%
Vhn - Plus	$487	548%
Gateway - Tier 2	$506	569%
Vhn	$506	569%
Integrated Health Plan	$537	604%
Vhn - Link	$569	640%
Gateway - Tier 1	$600	675%
Vhn - Secondary Payors	$600	675%
National Provider Network	$607	683%

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 $221.
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 Carilion Tazewell Community Hospital 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.