CMS Price Transparency Data

X-ray, hip

Facility: Adventist Health St Helena

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $304
Cash Discount Price: $108
vs. Medicare Baseline: 3.42x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Adventist Health St Helena is $304. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.42x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$304

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: $108 (121%)

Insurance Median: $304 (342%)

Cash: $108 (121% of Medicare)

Ins. Median: $304 (342% 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 342% of the Medicare baseline (a markup of 242%). 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
Blue Shield Epn-All Other Plans	$7 - $659	8%
Blue Shield Non-Epn	$8 - $649	9%
Blue Shield Bh Mcr Adv	$12 - $116	13%
Blue Shield Mcr Adv	$12 - $116	13%
Kaiser Mcr Adv	$12 - $116	13%
Tricare	$12 - $116	13%
Ah Employee Health Plan - All Plans	$13 - $208	15%
Cigna	$14 - $1,119	16%
Interplan-All Plans	$14 - $909	16%
Kaiser-All Other Plans	$14 - $1,147	16%
Western Growers-All Plans	$18 - $741	20%
Phcs-All Plans	$26 - $769	29%
Medi-Cal	$37	42%
Health Management Network-All Plans	$40 - $1,189	45%
Three Rivers-All Plans	$42 - $1,259	47%
Aetna	$47 - $198	53%
Va Medi-Cal	$53	60%
UnitedHealthcare	$58 - $892	65%
Healthnet-All Plans	$95	107%
Va Mcr - All Other Plans	$116	130%
Blue Shield Behav Hlth	$195 - $630	219%
Blue Cross Blue Shield	$297 - $396	334%
Choicecare-All Plans	$304 - $979	342%
Beech Street-All Plans	$326 - $1,049	367%
Galaxy Network-All Plans	$391 - $1,259	440%

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 $108.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73502.
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.