CMS Price Transparency Data

X-ray, shoulder

Facility: Lehigh Valley Hospital - Pocono

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $32
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Lehigh Valley Hospital - Pocono is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.36x the Medicare baseline. Located in 206 East Brown Street, East Stroudsburg, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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%)

Insurance Median: $32 (36%)

Ins. Median: $32 (36% 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
Amerihealth Caritas	$16 - $27	18%
Geisinger	$16 - $218	18%
UnitedHealthcare	$17 - $96	19%
Highmark Wholecare/Gateway	$18 - $32	20%
Aetna	$19 - $509	21%
Jefferson Health Partners	$20 - $184	22%
Pa Health & Wellness	$20 - $34	22%
Upmc	$24 - $447	27%
Highmark Blue Shield	$94 - $410	106%
Amerihealth	$95	107%
Cigna	$95	107%
Devoted Health	$97	109%
Humana	$97	109%
Gateway	$98	110%
Emblem	$99 - $531	111%
Pa Health & Wellness (Allwell)	$101	114%
Ambetter / Centene	$279	314%
Valley Preferred	$536	603%

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 $X.
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 Lehigh Valley Hospital - Pocono 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.