CMS Price Transparency Data

X-ray, shoulder

Facility: Capital Health Medical Center - Hopewell

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $511
Cash Discount Price: $7,030
vs. Medicare Baseline: 5.75x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Capital Health Medical Center - Hopewell is $511. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,030. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.75x the Medicare baseline. Located in One Capital Way, Pennington, NJ.

Cash / Self-Pay

$7,030

Average discount available for prompt cash payment at this facility.

Insurance Median

$511

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: $7,030 (7907%)

Insurance Median: $511 (575%)

Cash: $7,030 (7907% of Medicare)

Ins. Median: $511 (575% 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 575% of the Medicare baseline (a markup of 475%). 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
UnitedHealthcare	$28 - $511	31%
Medicaid / KanCare	$30 - $546	34%
Wellpoint	$30 - $552	34%
Aetna	$38 - $690	43%
Cigna	$50 - $9,586	56%
Horizon Nj Health	$56	63%
Blue Cross Blue Shield	$70 - $1,529	79%
Clover	$98	110%
Medicare (plans)	$99	111%
Humana	$100	112%
Fidelis	$154	173%
Oxford Benefit Plan	$180	202%
Multiplan	$599 - $10,865	674%

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 $7,030.
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 Capital Health Medical Center - Hopewell 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.