CMS Price Transparency Data

X-ray, shoulder

Facility: Kenmore Mercy Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $24
  • Cash Discount Price: $176
  • vs. Medicare Baseline: 0.27x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Kenmore Mercy Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.27x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.
Cash / Self-Pay
$176

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $176 (198%)
Insurance Median: $24 (27%)
Cash: $176 (198% of Medicare)
Ins. Median: $24 (27% 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 - $33 7%
VA Veterans Affairs [700001] $7 - $28 8%
Medicaid / KanCare $7 - $109 8%
Blue Cross Blue Shield $7 - $46 8%
Beacon Essential [350122] $8 - $40 9%
Univera Healthcare Essential [100170] $8 - $29 9%
Univera Healthcare [100169] $8 - $40 9%
Independent Health Essential [100166] $8 - $130 9%
Vna Option Mltc [350110] $8 - $20 9%
Excellus Rochester McD [350117] $8 - $22 9%
Crime Victims [100176] $8 - $22 9%
Tuscarora Nation [550120] $8 - $22 9%
Ghi [100153] $8 - $32 9%
Tricare $9 - $33 10%
Hospice [550001] $9 - $37 10%
Fidelis Dual Advantage [450120] $9 - $35 10%
Cigna $9 - $48 10%
Covid19 Hrsa [45013] $9 - $33 10%
Seneca Nation [450119] $9 - $33 10%
Champ VA [700002] $9 - $33 10%
Medicare (plans) $9 - $157 10%
Catholic Health Life Pace [400005] $9 - $33 10%
Aetna $9 - $35 10%
Wellcare Fidelis Dual [450451] $9 - $35 10%
Fallon Health [450115] $9 - $33 10%
Humana $9 - $35 10%
Independent Health [100165] $10 - $261 11%
Fidelis Essential [100163] $10 - $46 11%
Iha First Choice [800001] $10 - $170 11%
Wellcare [450129] $10 - $37 11%
Beacon Health Options [100023] $11 - $40 12%
Fidelis Exchange [100164] $11 - $40 12%
Mvp Healthcare [100168] $12 - $40 13%
Amerigroup [350102] $14 - $40 16%
UPMC Health Plan [100181] $16 - $60 18%
Molina Essential [100167] $18 - $45 20%
No Fault [114001] $33 - $84 37%
Federal Workers Compensation [500100] $33 - $84 37%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2950 Elmwood Avenue, Kenmore, NY 14217
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals