CMS Price Transparency Data

X-ray, shoulder

Facility: North Adams Regional Hospital Corporation

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $514
  • Cash Discount Price: $911
  • vs. Medicare Baseline: 5.78x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at North Adams Regional Hospital Corporation is $514. 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 5.78x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$911

Average discount available for prompt cash payment at this facility.

Insurance Median
$514

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: $514 (578%)
Cash: $911 (1025% of Medicare)
Ins. Median: $514 (578% 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 578% of the Medicare baseline (a markup of 478%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Wc Workers Comp $26 - $582 29%
Mcd Masshealth $27 - $143 30%
Mcd New York $27 - $71 30%
Mcd Out Of State $27 - $143 30%
Mcdmanaged Cdphp $27 - $143 30%
Mcdmanaged Hne Mcdaco $27 - $143 30%
Medicaid / KanCare $27 - $422 30%
Comm Network Qhpsub $30 - $542 34%
Mcdmanaged Network $30 - $542 34%
Mcdmanaged Bmchnp $31 - $149 35%
Tricare $35 - $361 39%
Comm Hospice $37 - $221 42%
Mcr Miscellaneous $37 - $221 42%
Mcrmanaged Usa Family $37 - $221 42%
Mcrmanaged Va $37 - $221 42%
Medicare (plans) $37 - $223 42%
Oth United Vaccn $37 - $221 42%
Blue Cross Blue Shield $42 - $815 47%
Mcrmanaged Cca One Care $42 - $218 47%
Aetna $44 - $724 49%
Comm Fallon Qhp $53 - $543 60%
Comm Unicare $63 - $622 71%
Comm Hne Hmo $66 - $632 74%
Comm Hne $70 - $669 79%
Comm Hne Ppo $70 - $672 79%
Comm Network Qhpnonsub $511 - $690 575%
Comm Nhp $516 - $621 580%
Comm Tufts $632 - $760 711%
UnitedHealthcare $686 - $825 772%
Cigna $718 - $892 808%
Comm Cdphp $718 - $863 808%
Comm Mvp $718 - $863 808%
Comm Oxford $718 - $863 808%
Comm First Health $742 - $911 835%
Comm Connecticare $758 - $911 853%
Comm Consolidated Health $758 - $911 853%
Comm Harvard $758 - $911 853%
Comm Other $758 - $911 853%
Comm Phcs $758 - $911 853%
Comm Self Pay $758 - $911 853%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals