CMS Price Transparency Data

X-ray, shoulder

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $237
  • Cash Discount Price: $497
  • vs. Medicare Baseline: 2.67x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Independence Health System Butler Memorial Hospita is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $497. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.67x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$497

Average discount available for prompt cash payment at this facility.

Insurance Median
$237

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: $497 (559%)
Insurance Median: $237 (267%)
Cash: $497 (559% of Medicare)
Ins. Median: $237 (267% 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 267% of the Medicare baseline (a markup of 167%). 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
Upmc $18 - $994 20%
Aetna $66 - $758 74%
Pnoa $74 - $758 83%
Ccbh - Behavioral Health $76 - $474 85%
Highmark $83 - $179 93%
Workers Comp $84 94%
Life Butler County $85 96%
Martin'S Point - Usfhp $85 - $331 96%
Medicare (plans) $85 96%
Peak Health $85 - $663 96%
Provider Partners $85 96%
Tricare $85 96%
UnitedHealthcare $85 - $217 96%
Humana $88 99%
Amerihealth $89 100%
Geisinger $89 - $947 100%
Highmark - Ind.& Managed Care $89 - $199 100%
Highmark Aca - Direct Blue $89 - $177 100%
Highmark Community Blue $89 - $177 100%
Devoted Health Plan $90 - $379 101%
The Health Plan $90 - $199 101%
Pa Health & Wellness $91 102%
American Health Plan $93 105%
Gateway $95 - $994 107%
Ellwood Group $142 - $407 160%
Cigna $194 - $474 218%
Private Healthcare Systems $332 - $805 373%
Devon $356 - $710 400%
Intergroup $379 - $758 426%
Multiplan $427 - $852 480%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals