CMS Price Transparency Data

X-ray, shoulder

Facility: Fairview Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $522
Cash Discount Price: $911
vs. Medicare Baseline: 5.87x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Fairview Hospital is $522. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $911. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.87x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.

Cash / Self-Pay

$911

Average discount available for prompt cash payment at this facility.

Insurance Median

$522

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: $911 (1025%)

Insurance Median: $522 (587%)

Cash: $911 (1025% of Medicare)

Ins. Median: $522 (587% 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 587% of the Medicare baseline (a markup of 487%). 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
Aetna	$23 - $724	26%
Workers Comp	$26 - $611	29%
Health New England	$27 - $669	30%
Medicaid / KanCare	$27 - $143	30%
Point32Health	$30 - $911	34%
Bmchnp	$31 - $149	35%
Other Government	$35 - $374	39%
Hospice	$37 - $374	42%
Medicare (plans)	$37 - $368	42%
UnitedHealthcare	$37 - $825	42%
Fallon	$38 - $422	43%
Blue Cross Blue Shield	$42 - $815	47%
Commcare Alliance	$44 - $367	49%
Comm Fallon Qhp	$53 - $591	60%
Unicare	$63 - $622	71%
Comm Hne Hmo	$66 - $632	74%
Comm Hne Ppo	$70 - $672	79%
Allways Nhp	$516 - $621	580%
Capital District Physicians' Health Plan	$718 - $863	808%
Cigna	$718 - $892	808%
Mvp	$718 - $863	808%
Oxford	$718 - $863	808%
First Health	$742 - $911	835%
Connecticare	$758 - $911	853%
Consolidated Health Plans	$758 - $911	853%
Other Commercial	$758 - $911	853%
Phcs	$758 - $911	853%
Self Pay	$758 - $911	853%

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 $911.
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 Fairview 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.