CMS Price Transparency Data

X-ray, shoulder

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $14
Cash Discount Price: $65
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at The University of Vermont Health Network-Alice Hy is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.16x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $65 (73%)

Insurance Median: $14 (16%)

Cash: $65 (73% of Medicare)

Ins. Median: $14 (16% 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
Blue Cross Blue Shield	$6 - $285	7%
Capital District Physicians' Health Plan	$6 - $111	7%
UnitedHealthcare	$6 - $116	7%
Fidelis Care	$7 - $38	8%
Humana	$7 - $38	8%
Mvp	$7 - $38	8%
Aetna	$9 - $101	10%
Choicecare	$9 - $88	10%
Martins Point	$9 - $38	10%
Veterans Affairs Community Care Network	$9 - $38	10%
Magnacare	$10 - $94	11%
Highmark Blueshield	$12 - $106	13%
St. Regis	$20 - $38	22%

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 $65.
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 The University of Vermont Health Network-Alice Hy 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.