CMS Price Transparency Data
X-ray, shoulder
Facility: Trinity Health Muskegon Hospital
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $233
- Cash Discount Price: $241
- vs. Medicare Baseline: 2.62x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Trinity Health Muskegon Hospital is $233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.62x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$241
Average discount available for prompt cash payment at this facility.
Insurance Median
$233
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: $241 (271%)
Insurance Median: $233 (262%)
Cash: $241 (271% of Medicare)
Ins. Median: $233 (262% 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 262% of the Medicare baseline (a markup of 162%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $49 - $140 | 55% |
| Medicaid / KanCare | $49 - $76 | 55% |
| Access Health | $65 | 73% |
| Bcn Domestic | $70 - $140 | 79% |
| Blue Benefit Administrators Of Massachusetts | $70 - $140 | 79% |
| Blue Care Network | $70 - $140 | 79% |
| Blue Distinction Transplant | $70 - $140 | 79% |
| Blue Shield - Ca | $70 - $140 | 79% |
| Blue Shield - Id (Regence) | $70 - $140 | 79% |
| Blue Shield - Ny Highmark Northeastern | $70 - $140 | 79% |
| Blue Shield - Ny Highmark Western | $70 - $140 | 79% |
| Blue Shield - Pa (Highmark) | $70 - $140 | 79% |
| Blue Shield - Wa (Regence) | $70 - $140 | 79% |
| Health Choices | $70 - $351 | 79% |
| Kaiser Domestic | $70 - $140 | 79% |
| U Of M Health Plan | $76 - $351 | 85% |
| Medicare (plans) | $85 - $131 | 96% |
| Aetna | $89 - $187 | 100% |
| Geha | $89 - $392 | 100% |
| Meritain | $89 | 100% |
| Blue Care Network Advantage | $91 - $131 | 102% |
| Align Senior Care | $93 - $131 | 105% |
| Correctional Recovery | $93 | 105% |
| Heartland Hospice | $93 | 105% |
| Hospice Harbor Hospice | $93 | 105% |
| UnitedHealthcare | $96 - $392 | 108% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $105 - $131 | 118% |
| Oscar | $119 | 134% |
| Molina Marketplace | $121 | 136% |
| Priority Health | $132 - $478 | 148% |
| Vitalcore | $144 - $220 | 162% |
| Wellpath | $144 | 162% |
| Acs Benefit Services | $154 - $231 | 173% |
| Allied Benefit Systems | $154 - $231 | 173% |
| Claimchoice Adminstrators | $154 - $231 | 173% |
| Consociate | $154 - $231 | 173% |
| Cypress Benefit Administrators | $154 - $231 | 173% |
| Forest County Potawatomi | $154 - $231 | 173% |
| Health Smart | $154 - $231 | 173% |
| Healthgram | $154 - $231 | 173% |
| Healthscope | $154 - $231 | 173% |
| Preferred One | $154 - $231 | 173% |
| Secureone Preferred United Plans | $154 - $231 | 173% |
| Sisco Benefits | $154 - $231 | 173% |
| The Health Plan | $154 - $231 | 173% |
| Trustmark Small Business Benefits | $154 - $231 | 173% |
| Unified Group Services | $154 - $231 | 173% |
| Webtpa | $154 - $231 | 173% |
| Asr Health Benefits | $157 - $236 | 177% |
| Hap | $157 - $353 | 177% |
| Wc Accident Fund | $158 - $237 | 178% |
| Wc Advantage | $158 - $237 | 178% |
| Wc Aig | $158 - $237 | 178% |
| Wc Allied | $158 - $237 | 178% |
| Wc Amerisure | $158 - $237 | 178% |
| Wc Amtrust | $158 - $237 | 178% |
| Wc Asu Risk Mgt | $158 - $237 | 178% |
| Wc Berkley Admin | $158 - $237 | 178% |
| Wc Broadspire | $158 - $237 | 178% |
| Wc Bunch & Associates | $158 - $237 | 178% |
| Wc Ccmsi | $158 - $237 | 178% |
| Wc Emc Insurance Company | $158 - $237 | 178% |
| Wc Esis | $158 - $237 | 178% |
| Wc Fcci | $158 - $237 | 178% |
| Wc Federated | $158 - $237 | 178% |
| Wc Gallagher Bassett | $158 - $237 | 178% |
| Wc Genex Care For Ohio | $158 - $237 | 178% |
| Wc Guard Insurance Company | $158 - $237 | 178% |
| Wc Hartford | $158 - $237 | 178% |
| Wc Liberty Mutual | $158 - $237 | 178% |
| Wc Meijers | $158 - $237 | 178% |
| Wc Michigan | $158 - $237 | 178% |
| Wc Mitchell Frankenmuth | $158 - $237 | 178% |
| Wc Pma | $158 - $237 | 178% |
| Wc Sedgwick | $158 - $237 | 178% |
| Wc Sentry | $158 - $237 | 178% |
| Wc Travelers | $158 - $237 | 178% |
| Wc Tristar | $158 - $237 | 178% |
| Wc Walmart | $158 - $237 | 178% |
| Wc Zurich | $158 - $237 | 178% |
| Hospice Of Michigan | $163 - $245 | 183% |
| Nomi Health | $166 - $249 | 187% |
| Varipro | $171 - $258 | 192% |
| Caresource | $186 - $280 | 209% |
| Cigna | $186 - $280 | 209% |
| 1199 National Benefit Fund | $222 - $334 | 250% |
| Allied National Global Care | $222 - $334 | 250% |
| Asrm - Reliance Standard Life Insurance | $222 - $334 | 250% |
| Christian Care Ministry | $222 - $334 | 250% |
| Dean Health | $222 - $334 | 250% |
| Fallon Health | $222 - $334 | 250% |
| Family Life Insurance Company | $222 - $334 | 250% |
| Ghc Scw | $222 - $334 | 250% |
| Group Pension Administrators | $222 - $334 | 250% |
| International Benefit Administrators | $222 - $334 | 250% |
| Lifetime Benefit Solutions | $222 - $334 | 250% |
| Manhattan Life | $222 - $334 | 250% |
| Medi Share | $222 - $334 | 250% |
| Multiplan | $222 - $334 | 250% |
| Mvp | $222 - $334 | 250% |
| Pai | $222 - $334 | 250% |
| Pan-American Life | $222 - $334 | 250% |
| Paramount Hmo | $222 - $334 | 250% |
| Phcs | $222 - $334 | 250% |
| Trinity Health Share | $222 - $334 | 250% |
| Acclaim | $233 - $351 | 262% |
| Administrative Concepts | $233 - $351 | 262% |
| Allegeant | $233 - $351 | 262% |
| Ameriben | $233 - $351 | 262% |
| American Family | $233 - $351 | 262% |
| American Healthcare Alliance | $233 - $351 | 262% |
| American Republic | $233 - $351 | 262% |
| Amerihealth | $233 - $351 | 262% |
| Aultcare | $233 - $351 | 262% |
| Automated Benefit Services | $233 - $351 | 262% |
| Auxiant | $233 - $351 | 262% |
| Benefit Administrative Systems,Llc | $233 - $351 | 262% |
| Boon Chapman | $233 - $351 | 262% |
| Cam Administrative Services | $233 - $351 | 262% |
| Christian Brother Services | $233 - $351 | 262% |
| Christian Brothers Holy Cross | $233 - $351 | 262% |
| Comprehensive Benefits | $233 - $351 | 262% |
| Continental Life Insurance | $233 - $351 | 262% |
| Custom Benefit Administrators | $233 - $351 | 262% |
| Employee Benefit Concepts | $233 - $351 | 262% |
| Employee Benefit Management | $233 - $351 | 262% |
| Enterprise Group Planning | $233 - $351 | 262% |
| Freedom Life Insurance Company | $233 - $351 | 262% |
| Group Administrators | $233 - $351 | 262% |
| Group Marketing Services | $233 - $351 | 262% |
| Guardian | $233 - $351 | 262% |
| Health America | $233 - $351 | 262% |
| Healthez | $233 - $351 | 262% |
| Humana | $233 - $351 | 262% |
| Insight | $233 - $351 | 262% |
| Intercare | $233 - $351 | 262% |
| Jfp Benefit Management | $233 - $351 | 262% |
| Jp Farley Corporation | $233 - $351 | 262% |
| Key Benefit Administrator | $233 - $351 | 262% |
| Liberty Union Life Assurance Co | $233 - $351 | 262% |
| Lucent Health | $233 - $351 | 262% |
| Luminare Health | $233 - $351 | 262% |
| Luminare Health (Detroit) | $233 - $351 | 262% |
| Medben | $233 - $351 | 262% |
| Medcost | $233 - $351 | 262% |
| Medical Mutual | $233 - $351 | 262% |
| Mutual Health Services | $233 - $351 | 262% |
| Mutual Of Omaha | $233 - $351 | 262% |
| Ncas | $233 - $351 | 262% |
| Nippon Life Ins | $233 - $351 | 262% |
| Nova | $233 - $351 | 262% |
| Painters Union Insurance Fund | $233 - $351 | 262% |
| Physicians Mutual | $233 - $351 | 262% |
| Plumbers Local 98 Insurance Fund | $233 - $351 | 262% |
| Prairie States | $233 - $351 | 262% |
| Primary Physician Care | $233 - $351 | 262% |
| Professional Benefit Administrators | $233 - $351 | 262% |
| The Loomis Company | $233 - $351 | 262% |
| Unicare | $233 - $351 | 262% |
| Us Health And Life | $233 - $351 | 262% |
| Valenz | $233 - $351 | 262% |
| Western & Southern Financial Group | $233 - $351 | 262% |
| Wps | $233 - $351 | 262% |
| First Health | $243 - $365 | 273% |
| Barinet | $296 - $445 | 333% |
| Cmh Allegan County | $296 - $445 | 333% |
| Cmh Barry County | $296 - $445 | 333% |
| Cmh Berrien County | $296 - $445 | 333% |
| Cmh Cass County | $296 - $445 | 333% |
| Cmh Kalamazoo | $296 - $445 | 333% |
| Cmh Kent County | $296 - $445 | 333% |
| Cmh Misc | $296 - $445 | 333% |
| Cmh Muskegon County | $296 - $445 | 333% |
| Cmh North Country | $296 - $445 | 333% |
| Cmh Northern Lakes County | $296 - $445 | 333% |
| Cmh Ottawa County | $296 - $445 | 333% |
| Cmh Van Buren County | $296 - $445 | 333% |
| Cmh West Mi County | $296 - $445 | 333% |