CMS Price Transparency Data

X-ray, shoulder

Facility: Southwestern Vermont Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $13
Cash Discount Price: $42
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Southwestern Vermont Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.15x the Medicare baseline. Located in 100 Hospital Drive, Bennington, VT.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $42 (47%)

Insurance Median: $13 (15%)

Cash: $42 (47% of Medicare)

Ins. Median: $13 (15% 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
Cdphp	$6 - $90	7%
Aetna	$8 - $90	9%
Blue Cross Blue Shield	$8 - $90	9%
Cigna	$8 - $90	9%
Fidelis	$8 - $94	9%
Hne	$8 - $90	9%
Humana	$8 - $90	9%
Mvp	$8 - $90	9%
UnitedHealthcare	$8 - $90	9%
Wellcare	$8 - $90	9%
Health New England	$10 - $15	11%
Allegiance	$12 - $18	13%
Bmc	$26	29%
Tufts	$65	73%

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 $42.
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 Southwestern Vermont Medical Center 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.