CMS Price Transparency Data

X-ray, shoulder

Facility: Saint Vincent Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $32
Cash Discount Price: $496
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Saint Vincent Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $496. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.36x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.

Cash / Self-Pay

$496

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $496 (558%)

Insurance Median: $32 (36%)

Cash: $496 (558% of Medicare)

Ins. Median: $32 (36% 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	$7 - $41	8%
Amerihealth	$9 - $101	10%
Highmark	$10 - $140	11%
Pennsylvania Health And Wellness	$11 - $37	12%
Geisinger	$12 - $40	13%
UnitedHealthcare	$12 - $2,587	13%
Cigna	$14 - $223	16%
Aetna	$18 - $195	20%
University Of Pittsburgh Medical Center	$19 - $96	21%
Highmark Wholecare	$23 - $102	26%
Jefferson Health Plans	$25 - $38	28%
Martin'S Point	$73 - $96	82%
American Health Plans	$96	108%
Life Pittsburgh	$96	108%
Medicare (plans)	$99	111%
Blue Cross Blue Shield	$101 - $151	114%
Humana	$102	115%
Molina	$104	117%
Medical Mutual	$204	229%

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 $496.
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 Saint Vincent 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.