CMS Price Transparency Data

X-ray, hand

Facility: Pocahontas Community Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $209
Cash Discount Price: $220
vs. Medicare Baseline: 2.35x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Pocahontas Community Hospital is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $220. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.35x the Medicare baseline. Located in 606 N W 7Th Street, Pocahontas, IA.

Cash / Self-Pay

$220

Average discount available for prompt cash payment at this facility.

Insurance Median

$209

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: $220 (247%)

Insurance Median: $209 (235%)

Cash: $220 (247% of Medicare)

Ins. Median: $209 (235% 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 235% of the Medicare baseline (a markup of 135%). 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
Molina	$110 - $220	124%
Wellpoint	$119 - $220	134%
Iowa Total Care	$122 - $220	137%
Aetna	$132 - $220	148%
Blue Cross Blue Shield	$141 - $220	159%
Health Partners	$208 - $209	234%
Humana	$209 - $220	235%
UnitedHealthcare	$211	237%
Cigna	$213	240%
Great West	$213	240%

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 $220.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pocahontas Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
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.