CMS Price Transparency Data

X-ray, shoulder

Facility: Adair County Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $173
Cash Discount Price: $225
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Adair County Memorial Hospital is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.95x the Medicare baseline. Located in 609 Se Kent, Greenfield, IA.

Cash / Self-Pay

$225

Average discount available for prompt cash payment at this facility.

Insurance Median

$173

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: $225 (253%)

Insurance Median: $173 (195%)

Cash: $225 (253% of Medicare)

Ins. Median: $173 (195% 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
UnitedHealthcare	$9 - $260	10%
Mahp-All Plans	$14 - $244	16%
Centivo-All Plans	$15 - $273	17%
Midlands Choice-All Plans	$20 - $315	22%
Aetna	$23 - $211	26%
Geha-All Plans	$33 - $309	37%
Iowa Total Care-All Plans	$36 - $306	40%
Wellmark Hmo	$63 - $73	71%
Wellmark Ppo - All Other Plans	$71 - $73	80%

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 $225.
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 Adair County Memorial Hospital 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.