CMS Price Transparency Data

X-ray, shoulder

Facility: St Francis Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $511
Cash Discount Price: $496
vs. Medicare Baseline: 5.75x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at St Francis Hospital is $511. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $496. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.75x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$496

Average discount available for prompt cash payment at this facility.

Insurance Median

$511

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: $496 (558%)

Insurance Median: $511 (575%)

Cash: $496 (558% of Medicare)

Ins. Median: $511 (575% 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 575% of the Medicare baseline (a markup of 475%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Wexford	$70 - $105	79%
Molina Healthcare	$73 - $152	82%
Meridian Health Plan	$77 - $115	87%
Blue Cross Blue Shield	$145 - $158	163%
Humana	$145	163%
Clear Spring Health of Illinois	$145	163%
UnitedHealthcare	$152 - $689	171%
Aetna	$152 - $484	171%
Amish Community	$193	217%
Celtic Insurance Company	$349	393%
Claim Doc	$362	407%
Hopetrust	$396	445%
Wellfirst	$443	498%
First Health	$511	575%
Caterpillar, Inc.	$553	622%
Current Health Solutions	$579	651%
Multiplan/Phcs	$586	659%
Consociate Group	$586	659%
Healthlink	$588	661%
Cigna	$613	689%
Provider Network of America	$620	697%
Healthcare Finest Network (Hfn)	$620	697%
Naphcare	$689	775%
Interplan	$689	775%
Live360	$689	775%
Illinois Breast and Cervical Cancer Program	$689	775%
Healthscope	$689	775%
Health Alliance Medical Plans	$689	775%

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 $496.
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 St Francis 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.