CMS Price Transparency Data

X-ray, shoulder

Facility: Catholic Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $178
Cash Discount Price: $858
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Catholic Medical Center is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $858. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.00x the Medicare baseline. Located in 100 McGregor Street, Manchester, NH.

Cash / Self-Pay

$858

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $858 (965%)

Insurance Median: $178 (200%)

Cash: $858 (965% of Medicare)

Ins. Median: $178 (200% 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 200% of the Medicare baseline (a markup of 100%). 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	$29 - $178	33%
Amerihealth Caritas	$65 - $130	73%
Well Sense Health Plan	$80 - $160	90%
Maine Community Health	$230 - $780	259%
United	$287 - $825	323%
Harvard Pilgrim	$301 - $622	339%
Tufts Health Plan	$375 - $814	422%

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 $858.
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 Catholic Medical Center 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.