CMS Price Transparency Data

X-ray, shoulder

Facility: Lehigh Valley Hospital - Macungie

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $52
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.58x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Lehigh Valley Hospital - Macungie is $52. 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 0.58x the Medicare baseline. Located in 3369 State Route 100, Macungie, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $52 (58%)

Ins. Median: $52 (58% 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
Geisinger	$18 - $394	20%
Highmark Wholecare/Gateway	$18 - $32	20%
Jefferson Health Partners	$20 - $179	22%
Pa Health & Wellness	$20 - $34	22%
Aetna	$21 - $448	24%
Amerihealth Caritas	$21 - $36	24%
Upmc	$24 - $437	27%
Blue Cross Blue Shield	$62 - $106	70%
Highmark Blue Shield	$91 - $241	102%
Humana	$91	102%
Amerihealth	$92	103%
Cigna	$92	103%
Gateway	$96	108%
Emblem	$97 - $400	109%
Pa Health & Wellness (Allwell)	$99	111%
Ambetter / Centene	$272	306%
Valley Preferred	$523	588%

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 - Macungie 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.