CMS Price Transparency Data

X-ray, shoulder

Facility: Geisinger-Lewistown Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $382
Cash Discount Price: $548
vs. Medicare Baseline: 4.30x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Geisinger-Lewistown Hospital is $382. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $548. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.30x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$548

Average discount available for prompt cash payment at this facility.

Insurance Median

$382

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: $548 (616%)

Insurance Median: $382 (430%)

Cash: $548 (616% of Medicare)

Ins. Median: $382 (430% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 430% of the Medicare baseline (a markup of 330%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$25	28%
Amerihealth	$27	30%
Geisinger Family Plan	$27	30%
Upmc Health Plan	$29 - $11,890	33%
Health Partners	$30	34%
Upmc Chip	$31	35%
Blue Cross Blue Shield	$85 - $478	96%
Geisinger Health Plan	$85 - $400	96%
Medicare (plans)	$85	96%
Advantra	$86	97%
Humana	$86	97%
Ambetter / Centene	$205	231%
Aetna	$361 - $430	406%
Cigna	$382 - $465	430%
UnitedHealthcare	$392	441%
Christian Healthcare Ministries	$442	497%
Christian Health Aid	$707	795%
Three Rivers Provider Network Inc.	$707	795%
Multiplan	$751	845%
Healthsmart Payors Organization	$796	895%

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 $548.
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 Geisinger-Lewistown 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.