CMS Price Transparency Data

X-ray, shoulder

Facility: Good Samaritan Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $110
Cash Discount Price: $107
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Good Samaritan Medical Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.24x the Medicare baseline. Located in 235 North Pearl Street, Brockton, MA.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $107 (120%)

Insurance Median: $110 (124%)

Cash: $107 (120% of Medicare)

Ins. Median: $110 (124% 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.

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
Unicare [8004]	$63	71%
Wellpoint [2034]	$63	71%
Blue Cross Blue Shield	$89 - $104	100%
Aetna	$93 - $104	105%
Meritain Health [1023]	$93	105%
Humana	$104	117%
Medicare (plans)	$104 - $110	117%
Neighborhood Pace [1206]	$104	117%
Ubh Hphc [8016]	$104	117%
United Community Plan [1202]	$104	117%
UnitedHealthcare	$104	117%
Veterans Admin [9003]	$104	117%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010]	$104	117%
Cca [1215]	$110	124%
Zzzcca Onecare [1216]	$110	124%
Eternalhealth [1227]	$111	125%
Harvard Pilgrim Health Care [8001]	$119	134%
Fallon [8008]	$136	153%
Mass General Brigham Health Plan Commercial [8009]	$138	155%
Mass General Brigham Health Plan Prime [7003]	$138	155%
Cigna	$143 - $291	161%
Senior Whole Health [1210]	$156	175%
Tufts [8002]	$248 - $291	279%
Hsn Bad Debt [4003]	$395	444%
Hsn Confidential [4007]	$395	444%
Hsn Dental [4006]	$395	444%
Hsn Partial [4002]	$395	444%
Hsn [4001]	$395	444%

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 $107.
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 Good Samaritan Medical Center 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.