CMS Price Transparency Data

X-ray, shoulder

Facility: St Joseph's Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $434
  • Cash Discount Price: $447
  • vs. Medicare Baseline: 4.88x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at St Joseph's Hospital is $434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $447. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.88x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$447

Average discount available for prompt cash payment at this facility.

Insurance Median
$434

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: $447 (503%)
Insurance Median: $434 (488%)
Cash: $447 (503% of Medicare)
Ins. Median: $434 (488% 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 488% of the Medicare baseline (a markup of 388%). 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 $69 78%
Molina Healthcare $113 - $170 127%
Meridian Health Plan $119 - $178 134%
Sae Hospice $124 139%
Clear Spring Health of Illinois $124 139%
UnitedHealthcare $124 - $621 139%
Blue Cross Blue Shield $124 139%
Aetna $124 - $434 139%
Humana $124 139%
Amish Community $174 196%
Naphcare $261 294%
Celtic Insurance Company $273 307%
Hopetrust $310 349%
Claim Doc $310 349%
Wellfirst $398 448%
First Health $459 516%
Healthlink $528 594%
Multiplan/Phcs $528 594%
Healthcare Finest Network (Hfn) $559 629%
Provider Network of America $559 629%
Current Health Solutions $621 698%
Healthscope $621 698%
Illinois Breast and Cervical Cancer Program $621 698%
Caterpillar, Inc. $621 698%
Mental Health Network $621 698%
Consociate Group $621 698%
Interplan $621 698%
Qtc Medical Group of Illinois $621 698%
Health Alliance Medical Plans $621 698%

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