CMS Price Transparency Data

X-ray, shoulder

Facility: Elkhart General Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $219
Cash Discount Price: $296
vs. Medicare Baseline: 2.46x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Elkhart General Hospital is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $296. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.46x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$296

Average discount available for prompt cash payment at this facility.

Insurance Median

$219

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: $296 (333%)

Insurance Median: $219 (246%)

Cash: $296 (333% of Medicare)

Ins. Median: $219 (246% 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 246% of the Medicare baseline (a markup of 146%). 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
Mclaren (Mi	$49	55%
UnitedHealthcare	$49 - $409	55%
Blue Cross Blue Shield	$58 - $275	65%
Caresource	$58 - $790	65%
Humana	$58 - $426	65%
Mdwise	$58 - $790	65%
Mhs	$58 - $790	65%
Devoted Healthcare	$61 - $122	69%
Aetna	$92 - $412	103%
Pace	$92	103%
Plain Church	$138 - $486	155%
Cha	$182 - $474	205%
Immergrun	$182 - $486	205%
Php	$198 - $426	223%
Cigna	$219 - $462	246%
Multiplan	$219 - $438	246%
Signature	$222 - $444	250%
Encore	$225 - $450	253%
Heartland	$304 - $608	342%

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 $296.
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 Elkhart General 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.