CMS Price Transparency Data

X-ray, shoulder

Facility: Frisbie Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $403
Cash Discount Price: $1,120
vs. Medicare Baseline: 4.53x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Frisbie Memorial Hospital is $403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,120. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.53x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$1,120

Average discount available for prompt cash payment at this facility.

Insurance Median

$403

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: $1,120 (1260%)

Insurance Median: $403 (453%)

Cash: $1,120 (1260% of Medicare)

Ins. Median: $403 (453% 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 453% of the Medicare baseline (a markup of 353%). 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
Blue Cross Blue Shield	$47 - $225	53%
Amerihealth Caritas	$73 - $175	82%
Well Sense Health Plan	$108 - $260	121%
Harvard Pilgrim	$236 - $862	265%
Maine Community Health	$253 - $1,029	285%
Tufts Health Plan	$305 - $1,218	343%
United	$305 - $1,284	343%
Aetna	$513 - $1,231	577%
Evernorth	$710 - $1,703	799%
Cigna	$3,033	3411%

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 $1,120.
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 Frisbie 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.