Delaware · 73020

X-Ray Of Shoulder, 1 View in Delaware

Delaware Medicare Avg
$11.25
39% above national avg
National Medicare Avg
$8.08
All states combined
Billed Charge (DE)
$68.88
What providers submit
Est. Commercial (DE)
$33.30
National avg: $24.08
Est. Cash / Self-Pay (DE)
$30.04
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

765
Services in DE
83
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Delaware

Provider Medicare Services
Galinat, Brian MD $15.83 181
Kane, Patrick MD $16.61 64
Pillai, Gita M.D. $16.84 44
Shin, Minchul M..D. $5.97 40

Delaware Pricing in Context

In Delaware, CPT code 73020 (X-Ray Of Shoulder, 1 View) carries an average Medicare payment of $11.25 — 39% above the national benchmark of $8.08. 83 providers across the state submitted claims for this procedure in 2023, performing 765 total services. Individual payments in DE ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Delaware is $68.88, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Delaware sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for X-Ray procedures, the estimated commercial insurance price in Delaware lands near $33.30, with self-pay cash prices typically around $30.04. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does X-Ray Of Shoulder, 1 View cost in Delaware?

The average Medicare payment for X-Ray Of Shoulder, 1 View in Delaware is $11.25, which is 39% above the national average of $8.08. Providers in DE typically bill $68.88 for this procedure.

What does X-Ray Of Shoulder, 1 View cost with insurance in Delaware?

With commercial insurance in Delaware, X-Ray Of Shoulder, 1 View costs an estimated $33.30. Without insurance, the estimated cash price is $30.04. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform X-Ray Of Shoulder, 1 View in Delaware?

83 providers in Delaware billed Medicare for X-Ray Of Shoulder, 1 View in 2023, performing 765 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is X-Ray Of Shoulder, 1 View cheaper in Delaware than the national average?

No — X-Ray Of Shoulder, 1 View costs 39% above the national average in Delaware. The state average Medicare payment is $11.25 compared to $8.08 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial