CMS Price Transparency Data

X-ray, shoulder

Facility: Crouse Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $109
Cash Discount Price: $231
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Crouse Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $231. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.23x the Medicare baseline. Located in 736 Irving Avenue, Syracuse, NY.

Cash / Self-Pay

$231

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $231 (260%)

Insurance Median: $109 (123%)

Cash: $231 (260% of Medicare)

Ins. Median: $109 (123% 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
Brighton Healthplan	$31 - $163	35%
Excellus	$31 - $293	35%
Fidelis	$31 - $240	35%
Healthfirst Health Plan	$31 - $51	35%
Molina	$31 - $103	35%
UnitedHealthcare	$31 - $338	35%
Wellcare	$31 - $171	35%
Mycompass	$32 - $168	36%
Aetna	$66 - $163	74%
Mvp	$69 - $342	78%
Cdphp	$109 - $163	123%
Emblemhealth	$109 - $163	123%
Humana	$109 - $163	123%
Martins Point	$109 - $163	123%
Nascentia	$109 - $163	123%
Emblem Health	$244 - $367	274%

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 $231.
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 Crouse 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.