CMS Price Transparency Data

X-ray, shoulder

Facility: Hospital of Univ of Pennsylvania

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $189
  • Cash Discount Price: $480
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Hospital of Univ of Pennsylvania is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $480. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.13x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$480

Average discount available for prompt cash payment at this facility.

Insurance Median
$189

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: $480 (540%)
Insurance Median: $189 (213%)
Cash: $480 (540% of Medicare)
Ins. Median: $189 (213% 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 213% of the Medicare baseline (a markup of 113%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $16 - $480 18%
Kaiser Permanente $17 - $480 19%
Keystone Mercy Health Plan $21 - $480 24%
Upmc $25 - $480 28%
Health Partners $27 - $480 30%
UnitedHealthcare $33 - $480 37%
Blue Cross Blue Shield $34 - $429 38%
Keystone Hmo Proactive $34 38%
Ibc Commercial Hpn $35 39%
Paired Kidney Exchange $38 43%
Gspp And Wissahickon Hospice $46 52%
Cigna $68 - $216 76%
Horizon Nj Health $81 - $84 91%
Medicare (plans) $91 - $93 102%
Philadelphia Va Medical Center $91 102%
Tricare $91 102%
Ibc $93 105%
Geisinger Health Plan $94 - $290 106%
Humana $94 - $384 106%
Devoted Health $96 108%
Pa Health And Wellness $96 - $151 108%
Penn Life (Living Independently For Elders) $96 108%
Aetna $97 - $480 109%
Clover Health Plan $99 111%
Keystone First $102 115%
Us Family Health Plan $105 118%
Preferred Health Care Eliance $106 119%
Pgm - Regie De L'Assurance Maladie Quebec $110 124%
Gateway Health Plan $113 127%
Elap $130 146%
Claims Watcher $146 - $165 164%
Oscar Health Plan $156 175%
Centivo $165 186%
Pgm - Kuwait Defense $168 - $216 189%
Elap Services $170 191%
Qualcare $182 205%
Olympus $189 213%
Coventry $192 - $245 216%
Highmark $192 216%
Pgm - Chop $192 216%
Wissahickon Hospice $192 216%
Healthamerica/Coventry $216 - $235 243%
First Health Global $240 270%
Penn Global Medicine $242 272%
Health Net $288 324%
Pgm - Royal Embassy Of Saudi Arabia $288 324%
Pgm - Embassy Of Qatar $312 351%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $312 351%
Interlink $322 362%
Pgm - Embassy Of The United Emirates/Ipc $336 378%
Health America/Ccn $384 432%
Intergroup $384 432%
Pgm - Kuwait Health Division $384 432%
Pgm - Kuwait Oil $384 432%
Preferred Care $384 432%
Blue Quality Centers For Transplant (Bqct) $480 540%
City Of Philadelphia Behavioral Health $480 540%
Commercial Other $480 540%
International Pfs $480 540%
Pa Medical Assistance $480 540%
United Behavioral Health $480 540%
Workers Compensation $480 540%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals