CMS Price Transparency Data

X-ray, shoulder

Facility: Southeast Iowa Regional Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $194
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.18x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Southeast Iowa Regional Medical Center is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.18x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$194

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%)

Insurance Median: $194 (218%)

Ins. Median: $194 (218% 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 218% of the Medicare baseline (a markup of 118%). 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
American Healthplan Of Iowa - Midlevel	$7	8%
Medicaid / KanCare	$7 - $8	8%
Aetna	$8 - $388	9%
American Healthplan Of Iowa - Md	$9	10%
Humana	$9	10%
Blue Cross Blue Shield	$15 - $99	17%
UnitedHealthcare	$17	19%
Midlands Choice	$19 - $466	21%
Plain Church	$70 - $337	79%
Absolute Solutions	$97 - $388	109%
First Agency	$97 - $388	109%
Multiplan	$97 - $388	109%
Henderson County	$103 - $409	116%
Wellpoint (Amerigroup)	$193 - $290	217%
Immugrun	$217 - $326	244%
Brighton Amish Church	$224 - $337	252%
6 Degree	$276 - $414	310%
Geha	$321 - $482	361%

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 $X.
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 Southeast Iowa Regional Medical Center 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.