CMS Price Transparency Data

X-ray, shoulder

Facility: Punxsutawney Area Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $33
Cash Discount Price: $92
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Punxsutawney Area Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.37x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $92 (103%)

Insurance Median: $33 (37%)

Cash: $92 (103% of Medicare)

Ins. Median: $33 (37% 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
Highmark Wholecare	$5 - $84	6%
UnitedHealthcare	$6 - $262	7%
Tricare	$8 - $82	9%
Aetna	$9 - $218	10%
Ambetter / Centene	$9 - $96	10%
Amerihealth Caritas	$9 - $89	10%
Cigna	$9 - $270	10%
Geisinger Health Plan	$9 - $91	10%
Highmark	$9 - $980	10%
United Mine Workers Of America	$9 - $91	10%
Upmc Health Plan	$9 - $95	10%
Pa Health And Wellness Commercial	$11 - $182	12%
Geisinger	$12 - $254	13%
Pa Workers Compensation	$50 - $454	56%
Humana	$89	100%

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 $92.
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 Punxsutawney Area 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.