CMS Price Transparency Data

X-ray, hand

Facility: Clarion Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $90
Cash Discount Price: $109
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Clarion Hospital is $90. 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 1.01x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $90 (101%)

Cash: $109 (123% of Medicare)

Ins. Median: $90 (101% 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
Upmc	$14 - $98	16%
Highmark	$66 - $141	74%
Highmark - Ind.& Managed Care	$66 - $190	74%
Martin'S Point - Usfhp	$68 - $85	76%
Workers Comp	$71	80%
Gateway	$72 - $91	81%
Devoted Health Plan	$78 - $90	88%
Highmark Community Blue	$84	94%
Amerihealth	$85	96%
Cigna	$85 - $98	96%
Medicare (plans)	$85	96%
Tricare	$85	96%
UnitedHealthcare	$85	96%
Aetna	$87 - $195	98%
Geisinger	$89	100%
The Health Plan	$90 - $199	101%
Pa Health & Wellness	$91	102%
American Health Plan	$93	105%
Peak Health	$136 - $199	153%
Devon	$146	164%

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: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Clarion Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
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.