CMS Price Transparency Data

X-ray, shoulder

Facility: Sheridan Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $187
Cash Discount Price: $110
vs. Medicare Baseline: 2.10x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Sheridan Memorial Hospital is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.10x the Medicare baseline. Located in 1401 W 5Th St, Sheridan, WY.

Cash / Self-Pay

$110

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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: $110 (124%)

Insurance Median: $187 (210%)

Cash: $110 (124% of Medicare)

Ins. Median: $187 (210% 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 210% of the Medicare baseline (a markup of 110%). 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
Humana	$9 - $95	10%
Pacificsource-All Plans	$48 - $229	54%
Wise Provider Network-All Plans	$48 - $242	54%
Medi-Share Profee Only - All Plans	$49 - $60	55%
Miscellaneous-All Plans	$49 - $234	55%
Cigna	$50 - $242	56%
First Choice Comm - All Plans	$51 - $247	57%
Phcs Multiplan-All Plans	$51 - $247	57%
Three Rivers-All Plans	$51 - $247	57%
Blue Cross Blue Shield	$80 - $216	90%
Wy School Boards-All Plans	$174 - $217	196%
UnitedHealthcare	$178 - $223	200%
C1 Employee - All Plans	$187 - $234	210%
Casper Opco Llc - All Plans	$187 - $234	210%
First Health Comm - All Plans	$187 - $234	210%
Ebms - All Plans	$198 - $247	223%

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 $110.
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 Sheridan Memorial 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.