CMS Price Transparency Data

X-ray, shoulder

Facility: Helen Newberry Joy Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $22
Cash Discount Price: $14
vs. Medicare Baseline: 0.25x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Helen Newberry Joy Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.25x the Medicare baseline. Located in 502 W Harrie St, Newberry, MI.

Cash / Self-Pay

$14

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $14 (16%)

Insurance Median: $22 (25%)

Cash: $14 (16% of Medicare)

Ins. Median: $22 (25% 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
Mi Wc - All Plans	$14 - $132	16%
Aetna	$19 - $321	21%
Uphg Tpa - All Plans	$19 - $186	21%
First Health - All Plans	$20 - $196	22%
Ppom/Cofinity - All Plans	$20 - $196	22%
Blue Cross Blue Shield	$21 - $321	24%
Cigna	$21 - $200	24%
Health Alliance - All Plans	$21 - $200	24%
Healtheos - All Plans	$21 - $200	24%
Priority Health - All Plans	$21 - $200	24%
UnitedHealthcare	$21 - $200	24%
Vital Core - All Plans	$21 - $200	24%
Humana	$83 - $321	93%
Mi Health Link - All Plans	$83 - $321	93%
Va - All Plans	$85 - $253	96%
Uphp Mcaid - All Plans	$97 - $229	109%

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 $14.
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 Helen Newberry Joy 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.