CMS Price Transparency Data

X-ray, shoulder

Facility: Porter Hospital Inc

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $41
  • Cash Discount Price: $260
  • vs. Medicare Baseline: 0.46x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Porter Hospital Inc is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.46x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.
Cash / Self-Pay
$260

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $260 (292%)
Insurance Median: $41 (46%)
Cash: $260 (292% of Medicare)
Ins. Median: $41 (46% 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.

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
UnitedHealthcare $6 - $466 7%
Mvp $7 - $439 8%
Fidelis Care $8 - $199 9%
Humana $8 - $84 9%
Aetna $9 - $221 10%
Capital District Physicians' Health Plan $9 - $393 10%
Martins Point $9 - $221 10%
Veterans Affairs Community Care Network $9 - $221 10%
Veterans Choice $9 - $221 10%
Blue Cross Blue Shield $10 - $444 11%
Harvard Pilgrim $10 - $377 11%
Coventry $11 - $414 12%
Cigna $13 - $428 15%
Wellpath $26 - $259 29%
Medical Corporation $46 - $447 52%
Multiplan $46 - $447 52%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 115 Porter Drive, Middlebury, VT 05753
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals