CMS Price Transparency Data

X-ray, shoulder

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $40
Cash Discount Price: $249
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Munson Healthcare Otsego Memorial Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.45x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$249

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $249 (280%)

Insurance Median: $40 (45%)

Cash: $249 (280% of Medicare)

Ins. Median: $40 (45% 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
Blue Cross Blue Shield	$6 - $183	7%
Mclaren Health Plan	$6 - $246	7%
Meridian	$6 - $45	7%
Molina	$6 - $94	7%
Priority Health	$6 - $87	7%
UnitedHealthcare	$6 - $235	7%
Aetna	$9 - $237	10%
Blue Care Network	$9 - $87	10%
Hap (Health Alliance Plan)	$9 - $234	10%
Humana	$9 - $87	10%
Medicare (plans)	$9 - $87	10%
Michigan Amish Medical Board	$9 - $87	10%
Northern Michigan Mennonite Group	$9 - $87	10%
Asr Physicians Care Network	$13 - $234	15%
Cigna	$14 - $85	16%
Nomi Health	$14 - $234	16%
Employee Benefit Logistics	$15 - $147	17%
Munson Hospice	$146 - $852	164%
Hospice Of Michigan	$176	198%
Enterprise Group Planning/Employee Benefit Plan	$234	263%
Cofinity	$249	280%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$249	280%
Three Rivers Provider Network	$249	280%

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 $249.
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 Munson Healthcare Otsego Memorial 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.