CMS Price Transparency Data

X-ray, hand

Facility: St Joseph's Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73130
  • Insurance Median: $424
  • Cash Discount Price: $436
  • vs. Medicare Baseline: 4.77x Medicare
The contracted insurance negotiated median rate for a X-ray, hand at St Joseph's Hospital is $424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $436. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.77x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$436

Average discount available for prompt cash payment at this facility.

Insurance Median
$424

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: $436 (490%)
Insurance Median: $424 (477%)
Cash: $436 (490% of Medicare)
Ins. Median: $424 (477% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 477% of the Medicare baseline (a markup of 377%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Cigna $76 85%
Molina Healthcare $113 - $170 127%
Meridian Health Plan $119 - $178 134%
Clear Spring Health of Illinois $121 136%
Blue Cross Blue Shield $121 136%
Humana $121 136%
UnitedHealthcare $121 - $606 136%
Aetna $121 - $424 136%
Sae Hospice $121 136%
Amish Community $170 191%
Naphcare $255 287%
Celtic Insurance Company $267 300%
Hopetrust $303 341%
Claim Doc $303 341%
Wellfirst $388 436%
First Health $448 504%
Multiplan/Phcs $515 579%
Healthlink $515 579%
Healthcare Finest Network (Hfn) $545 613%
Provider Network of America $545 613%
Current Health Solutions $606 682%
Qtc Medical Group of Illinois $606 682%
Consociate Group $606 682%
Interplan $606 682%
Health Alliance Medical Plans $606 682%
Illinois Breast and Cervical Cancer Program $606 682%
Healthscope $606 682%
Mental Health Network $606 682%
Caterpillar, Inc. $606 682%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals