CMS Price Transparency Data

X-ray, shoulder

Facility: Mercyone Clinton Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $186
  • Cash Discount Price: $353
  • vs. Medicare Baseline: 2.09x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercyone Clinton Medical Center is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $353. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.09x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$353

Average discount available for prompt cash payment at this facility.

Insurance Median
$186

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: $353 (397%)
Insurance Median: $186 (209%)
Cash: $353 (397% of Medicare)
Ins. Median: $186 (209% 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 209% of the Medicare baseline (a markup of 109%). 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
Iowa Total Care $80 90%
Medicaid / KanCare $81 91%
Bcn Domestic $89 100%
Blue Benefit Administrators Of Massachusetts $89 100%
Blue Care Network $89 100%
Blue Cross Blue Shield $89 - $92 100%
Blue Distinction Transplant $89 100%
Blue Shield - Ca $89 100%
Blue Shield - Id (Regence) $89 100%
Blue Shield - Ny Highmark Northeastern $89 100%
Blue Shield - Ny Highmark Western $89 100%
Blue Shield - Pa (Highmark) $89 100%
Blue Shield - Wa (Regence) $89 100%
Kaiser Domestic $89 100%
Pre-Employment $89 100%
Wc Domestic $89 100%
Aetna $91 - $570 102%
Medicare (plans) $91 - $94 102%
UnitedHealthcare $93 - $652 105%
Amish Hospital Aid $123 138%
Health Choices $123 - $185 138%
Medical Associates $123 - $185 138%
Oscar $126 142%
Preferred Health Choice $126 - $188 142%
Ambetter / Centene $156 175%
Claimdoc $186 209%
Nova $186 209%
Geha $195 - $391 219%
The Alliance $264 - $395 297%
1199 National Benefit Fund $381 - $570 429%
Allied Benefit Systems $381 - $570 429%
Asr Health Benefits $381 - $570 429%
Christian Brother Services $381 - $570 429%
Coventry $381 - $570 429%
First Health $381 - $570 429%
Lucent Health $381 - $570 429%
Luminare Health $381 - $570 429%
Medical Mutual $381 - $570 429%
Meritain $381 - $570 429%
Trustmark Small Business Benefits $381 - $570 429%
Webtpa $381 - $570 429%
Health Partners $382 - $572 430%
Auxiant $392 - $587 441%
Cigna $392 - $587 441%
Medica $392 - $587 441%
Midlands $392 - $587 441%
Midlands Choice $392 - $587 441%
Multiplan $392 - $587 441%
Qualcare $392 - $587 441%
Usa Managed Care $413 - $619 465%
Crime Victim Assistance $435 - $652 489%
Iowa Dept Of Public Health $435 - $652 489%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals