CMS Price Transparency Data

X-ray, shoulder

Facility: UPMC Chautauqua at Wca

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $143
Cash Discount Price: $134
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at UPMC Chautauqua at Wca is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.61x the Medicare baseline. Located in 207 Foote Avenue, Jamestown, NY.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $134 (151%)

Insurance Median: $143 (161%)

Cash: $134 (151% of Medicare)

Ins. Median: $143 (161% 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
Univera	$36	40%
Magnacare	$46 - $167	52%
Independent Health	$93 - $118	105%
Beacon	$108 - $134	121%
Fidelis	$108	121%
Humana	$108 - $178	121%
United Behavioral Health	$108	121%
UnitedHealthcare	$108 - $145	121%
Upmc Health Plan	$108 - $134	121%
Wellcare	$111	125%
Aetna	$112 - $145	126%
Geisinger	$123	138%
Multiplan	$167	188%
Ghi/Emblem Health	$178	200%
Statewide Independent Ppo	$196	220%
Affordable First Health	$201	226%
Blue Cross Blue Shield	$270	304%

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 $134.
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 UPMC Chautauqua at Wca 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.