CMS Price Transparency Data

X-ray, shoulder

Facility: St Marys Rehabilitation Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $305
  • Cash Discount Price: $305
  • vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at St Marys Rehabilitation Hospital is $305. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.43x the Medicare baseline. Located in 1208 Langhorne Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$305

Average discount available for prompt cash payment at this facility.

Insurance Median
$305

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: $305 (343%)
Insurance Median: $305 (343%)
Cash: $305 (343% of Medicare)
Ins. Median: $305 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
Aetna $295 - $318 332%
Ambetter / Centene $295 - $318 332%
Cigna $295 - $318 332%
Humana $295 - $318 332%
Ibc - Keycare 65 - Tier 2 $295 - $318 332%
Ibc - Keycare 65 - Tier 3 $295 - $318 332%
Ibc - Keystone Health Plan East - Tier 2 $295 - $318 332%
Ibc - Keystone Health Plan East - Tier 3 $295 - $318 332%
Ibc - Personal Choice - Tier 2 $295 - $318 332%
Ibc - Personal Choice - Tier 3 $295 - $318 332%
Ibc - Personal Choice 65 - Tier 2 $295 - $318 332%
Ibc - Personal Choice 65 - Tier 3 $295 - $318 332%
Keystone First Vip Choice $295 - $318 332%
Keystone First/ Community Health Choices $295 - $318 332%
Medicaid / KanCare $295 - $318 332%
Medicare (plans) $295 - $318 332%
Pa Health & Wellness $295 - $318 332%
UnitedHealthcare $295 - $318 332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1208 Langhorne Newtown Rd, Langhorne, PA 19047
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL