CMS Price Transparency Data

X-ray, shoulder

Facility: Vandalia Health Broaddus Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $145
Cash Discount Price: $139
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Vandalia Health Broaddus Hospital is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.63x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.

Cash / Self-Pay

$139

Average discount available for prompt cash payment at this facility.

Insurance Median

$145

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: $139 (156%)

Insurance Median: $145 (163%)

Cash: $139 (156% of Medicare)

Ins. Median: $145 (163% 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
Correctional Medical Systems	$6 - $23	7%
Aetna	$7 - $177	8%
The Health Plan	$7 - $178	8%
Unicare	$7 - $24	8%
Blue Cross Blue Shield	$16 - $140	18%
Peak Health	$34 - $63	38%
Highmark	$145	163%
UnitedHealthcare	$147 - $192	165%
Humana	$152	171%
West Virginia Senior Advantage	$154	173%
Cigna	$173	195%
First Health	$177	199%
Geisenger Health Plan	$184	207%
Health Network America	$184 - $188	207%
Multiplan/Phcs	$186	209%
Geha	$188	211%
Selectnet	$194	218%

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 $139.
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 Vandalia Health Broaddus Hospital 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.