CMS Price Transparency Data

X-ray, shoulder

Facility: Othello Community Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $288
  • Cash Discount Price: $270
  • vs. Medicare Baseline: 3.24x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Othello Community Hospital is $288. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.24x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.
Cash / Self-Pay
$270

Average discount available for prompt cash payment at this facility.

Insurance Median
$288

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: $270 (304%)
Insurance Median: $288 (324%)
Cash: $270 (304% of Medicare)
Ins. Median: $288 (324% 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 324% of the Medicare baseline (a markup of 224%). 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
Ambetter / Centene $153 - $155 172%
Amerigroup Mcaid $153 172%
Chp Mcaid $153 172%
Cocare - All Plans $153 172%
Gau - All Plans $153 172%
Kaiser - All Plans $153 172%
Molina Mcaid $153 172%
UnitedHealthcare $153 - $360 172%
Chp - All Other Plans $155 174%
Molina - All Other Plans $155 174%
Medicare (plans) $180 202%
Tricare $234 263%
Triwest - All Plans $234 263%
Asuris - All Plans $288 324%
Commercial Other - All Plans $288 324%
Hma - All Plans $288 324%
Hmso - All Plans $288 324%
Tpsc - All Plans $288 324%
Travelers - All Plans $288 324%
Veterans Admin - All Plans $288 324%
Blue Cross Blue Shield $303 341%
Cigna $321 361%
First Choice - All Plans $324 364%
Aetna $339 381%
Chp Mcr Adv $360 405%
Health Alliance Mcr Adv - All Plans $360 405%
Humana $360 405%
Molina Mcare $360 405%
Wellcare Mcr Adv - All Plans $360 405%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 North 14Th Avenue, Othello, WA 99344
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals