CMS Price Transparency Data

X-ray, shoulder

Facility: Franciscan Health Michigan City

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $512
Cash Discount Price: $228
vs. Medicare Baseline: 5.76x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Franciscan Health Michigan City is $512. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.76x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$228

Average discount available for prompt cash payment at this facility.

Insurance Median

$512

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: $228 (256%)

Insurance Median: $512 (576%)

Cash: $228 (256% of Medicare)

Ins. Median: $512 (576% 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 576% of the Medicare baseline (a markup of 476%). 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
Mdwise [1175]	$58	65%
Medicaid / KanCare	$58 - $69	65%
Managed Health Services [1302]	$59	66%
Blue Cross Blue Shield	$68 - $732	76%
Unicare [1150]	$68 - $318	76%
Medicare (plans)	$90 - $92	101%
Workers Comp [1172]	$180 - $184	202%
Aetna	$186 - $372	209%
Managed Care [2000]	$186 - $1,318	209%
Commercial [2001]	$391 - $1,464	440%
Cigna	$442 - $1,025	497%
Great West Insurance [1055]	$442 - $884	497%
United Medical Resources [1158]	$512	576%
United Medical Resources [1301]	$512 - $562	576%
UnitedHealthcare	$512 - $562	576%

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 $228.
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 Franciscan Health Michigan City 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.