CMS Price Transparency Data

X-ray, shoulder

Facility: St Joseph's University Medical Center Inc

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $57
Cash Discount Price: $405
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at St Joseph's University Medical Center Inc is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $405. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.64x the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$405

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $405 (456%)

Insurance Median: $57 (64%)

Cash: $405 (456% of Medicare)

Ins. Median: $57 (64% 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
Fidelis Care of New Jersey	$7 - $162	8%
UnitedHealthcare	$7 - $144	8%
Aetna	$10 - $211	11%
Ambetter / Centene	$10 - $155	11%
Amerihealth	$10 - $516	11%
Clover Health	$10 - $103	11%
Horizon New Jersey Total Care	$10 - $103	11%
Wellpoint	$10 - $159	11%
Blue Cross Blue Shield	$11 - $294	12%
Multiplan	$15 - $608	17%
Private Healthcare Systems	$20 - $527	22%
Horizon New Jersey Health	$27 - $103	30%
Cigna	$31 - $811	35%
Consumer Health Network	$43 - $730	48%
Longevity Health Plan	$119	134%
Oxford	$130	146%
Magnacare	$284 - $568	319%
Oscar	$382 - $764	430%

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 $405.
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 St Joseph's University Medical Center Inc 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.