CMS Price Transparency Data

X-ray, shoulder

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $85
Cash Discount Price: $112
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Iowa Specialty Hospital - Clarion is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.96x the Medicare baseline. Located in 1316 South Main Street, Clarion, IA.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $112 (126%)

Insurance Median: $85 (96%)

Cash: $112 (126% of Medicare)

Ins. Median: $85 (96% 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.

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
Aetna	$9 - $278	10%
Tricare	$9 - $101	10%
Triwest Va - All Plans	$9 - $101	10%
Healthscope Stellar-All Plans	$14 - $173	16%
Health Partners Ish-All Other Plans	$17 - $262	19%
Wellmark Hmo	$18 - $109	20%
Wellmark Ppo - All Other Plans	$20 - $120	22%
UnitedHealthcare	$24 - $311	27%
Auxiant Clarion Schools-All Plans	$29 - $213	33%
Health Partners Prestage	$34 - $245	38%
Cigna	$68 - $317	76%
Midlands Choice-All Plans	$68 - $317	76%

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 $112.
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 Iowa Specialty Hospital - Clarion 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.