CMS Price Transparency Data

X-ray, shoulder

Facility: Astria Sunnyside Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $334
Cash Discount Price: $465
vs. Medicare Baseline: 3.76x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Astria Sunnyside Hospital is $334. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $465. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.76x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$465

Average discount available for prompt cash payment at this facility.

Insurance Median

$334

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: $465 (523%)

Insurance Median: $334 (376%)

Cash: $465 (523% of Medicare)

Ins. Median: $334 (376% 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 376% of the Medicare baseline (a markup of 276%). 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
Medicare (plans)	$41 - $206	46%
Medicaid / KanCare	$156 - $250	175%
Aetna	$200 - $717	225%
Healthcomp_Ihs	$200	225%
Humana	$200 - $734	225%
Molina	$200	225%
Va	$200	225%
Tricare	$202	227%
Regence	$419	471%
Cigna	$489	550%
Li	$500	562%
First_Choice	$611	687%
Tpsc	$636	715%
Kaiser	$640	720%
Premera	$663	746%
UnitedHealthcare	$693	779%
Fhpw	$717	806%
Healthcomp	$734	826%
Bcchp	$815	917%
Great_Rivers	$815	917%
Zenith	$815	917%

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 $465.
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 Astria Sunnyside 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.