CMS Price Transparency Data

X-ray, shoulder

Facility: Arnot Ogden Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $360
Cash Discount Price: $468
vs. Medicare Baseline: 4.05x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Arnot Ogden Medical Center is $360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $468. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.05x the Medicare baseline. Located in 600 Roe Avenue, Elmira, NY.

Cash / Self-Pay

$468

Average discount available for prompt cash payment at this facility.

Insurance Median

$360

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: $468 (526%)

Insurance Median: $360 (405%)

Cash: $468 (526% of Medicare)

Ins. Median: $360 (405% 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 405% of the Medicare baseline (a markup of 305%). 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
Empire	$7 - $34	8%
Fidelis	$15 - $98	17%
Amerihealth	$25	28%
Blue Cross Blue Shield	$34 - $2,901	38%
Aetna	$89 - $717	100%
Geisinger	$91 - $292	102%
Humana	$102 - $860	115%
Tricare	$102	115%
Amerihealth Mcr Adv - All Plans	$103	116%
Fidelis Care-Exchange - All Plans	$252 - $526	283%
Geisinger - All Plans	$267 - $556	300%
Cigna	$286 - $596	322%
Mvp Health Plan - All Plans	$286 - $596	322%
Independent Health - All Plans	$298 - $621	335%
UnitedHealthcare	$317 - $660	357%
Upmc Health Plan - All Plans	$317 - $660	357%
Pomco Inc - All Plans	$331 - $688	372%
Emblem Health - All Plans	$404 - $841	454%
Emblem/Ghi	$424 - $441	477%
Martins Point Mcr Adv - All Plans	$459 - $956	516%
Healthnow - All Plans	$1,383 - $2,880	1556%

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 $468.
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 Arnot Ogden 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.