CMS Price Transparency Data

X-ray, shoulder

Facility: Witham Health Services

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $600
Cash Discount Price: $537
vs. Medicare Baseline: 6.75x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Witham Health Services is $600. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $537. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.75x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$537

Average discount available for prompt cash payment at this facility.

Insurance Median

$600

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: $537 (604%)

Insurance Median: $600 (675%)

Cash: $537 (604% of Medicare)

Ins. Median: $600 (675% 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 675% of the Medicare baseline (a markup of 575%). 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
Blue Cross Blue Shield	$15 - $686	17%
Mdwise Health In-All Plans	$92	103%
Caresource Mcr Adv	$94	106%
Aetna	$95 - $645	107%
Caresource Indiana Marketplace-All Other Plans	$175	197%
UnitedHealthcare	$516 - $680	580%
Phcs/Multiplan-All Plans	$602 - $793	677%
Sagamore-All Plans	$609 - $802	685%
Humana	$615 - $810	692%
Beech Street-All Plans	$622 - $819	700%
Encore-All Plans	$628 - $828	706%
Mhs Comml Exch-All Plans	$1,654 - $2,179	1860%

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 $537.
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 Witham Health Services 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.