CMS Price Transparency Data

X-ray, shoulder

Facility: Montefiore St Luke's Cornwall

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

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

The contracted insurance negotiated median rate for a X-ray, shoulder at Montefiore St Luke's Cornwall is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.23x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

$109

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: $109 (123%)

Insurance Median: $109 (123%)

Cash: $109 (123% 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
Affinity	$15 - $114	17%
Emblem	$15 - $476	17%
Healthfirst	$15 - $109	17%
Medicaid / KanCare	$15	17%
Aetna	$47 - $108	53%
Geha	$52	58%
Meritain Health	$52	58%
Nippon Life Insurance	$52	58%
Fidelis	$87 - $126	98%
Mediblue	$105	118%
Blue Cross Blue Shield	$109 - $235	123%
Cdphp	$109	123%
Hudson Valley	$109	123%
Oscar	$109 - $172	123%
Point Comfort	$109	123%
UnitedHealthcare	$109 - $129	123%
Villagecaremax	$109	123%
Vnsny Choice	$109	123%
Centerlight	$112	126%
Wellcare	$112	126%
Hamaspik	$117	132%
Humana	$119	134%
American Postal Workers	$129	145%
Cigna	$194 - $215	218%
Mvp	$282	317%
Northwell	$292	328%
Centivo	$375	422%
Seiu1199	$446	502%

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 $109.
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 Montefiore St Luke's Cornwall 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.