CMS Price Transparency Data

X-ray, shoulder

Facility: Glens Falls Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $39
Cash Discount Price: $105
vs. Medicare Baseline: 0.44x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Glens Falls Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.44x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$105

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $105 (118%)

Insurance Median: $39 (44%)

Cash: $105 (118% of Medicare)

Ins. Median: $39 (44% 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
Aetna	$9 - $224	10%
Medicaid / KanCare	$20 - $31	22%
Cdphp	$22 - $135	25%
Medicare (plans)	$24 - $32	27%
UnitedHealthcare	$24 - $195	27%
Blue Cross Blue Shield	$25 - $149	28%
Blue Shield	$27 - $81	30%
Emblem Health Ghi	$27 - $32	30%
Mvp Commercial	$28 - $116	31%
Mvp	$29 - $126	33%
Tricare	$31 - $32	35%
Fidelis	$32 - $137	36%
Blue Shield Highmark	$37 - $90	42%
Cigna	$45 - $54	51%
Hamaspik	$136 - $149	153%
Nascentia Health Options	$136 - $149	153%
Magnacare	$157 - $172	177%
Emblem	$167 - $183	188%
Empire Plan Nyship	$178 - $195	200%
Multiplan	$178 - $195	200%

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 $105.
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 Glens Falls 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.