CMS Price Transparency Data

X-ray, shoulder

Facility: University of Michigan Health - West

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $278
Cash Discount Price: $166
vs. Medicare Baseline: 3.13x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at University of Michigan Health - West is $278. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.13x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$278

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: $166 (187%)

Insurance Median: $278 (313%)

Cash: $166 (187% of Medicare)

Ins. Median: $278 (313% 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 313% of the Medicare baseline (a markup of 213%). 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
Medicaid / KanCare	$48 - $98	54%
Molina Healthcare Of Mi	$48	54%
Aetna	$70 - $278	79%
Priority Health	$74	83%
Care Resources	$80	90%
Humana	$89 - $311	100%
Insight Metro Care	$89	100%
Medicare (plans)	$89	100%
Molina Marketplace Commercial	$89	100%
Web Tpa	$182	205%
Alliance Health & Life Ppo	$278	313%
Asr Physicians	$278	313%
Hap	$278	313%
Golden Rule Ins	$299	336%
Medica	$299	336%
Student Ins/Mega Life	$299	336%
UnitedHealthcare	$299	336%
Asr Cofinity	$346	389%
Cofinity Commercial	$346	389%
Cofinity Weyco	$346	389%
Core Source	$346	389%
Epoch Group	$346	389%
Health Partners	$346	389%
Hlthcomp Admin	$346	389%
Mid America	$346	389%

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 $166.
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 University of Michigan Health - West 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.