CMS Price Transparency Data

X-ray, shoulder

Facility: Veterans Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $130
Cash Discount Price: $170
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Veterans Memorial Hospital is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.46x the Medicare baseline. Located in 40 1St Street Se, Waukon, IA.

Cash / Self-Pay

$170

Average discount available for prompt cash payment at this facility.

Insurance Median

$130

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: $170 (191%)

Insurance Median: $130 (146%)

Cash: $170 (191% of Medicare)

Ins. Median: $130 (146% 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
Humana	$7 - $226	8%
Aetna	$9 - $202	10%
Amerigroup Mcr Adv	$9 - $130	10%
Iowa Total Care Exchange	$9 - $130	10%
Molina Mcr Adv	$9 - $130	10%
Quartz Mcr Adv	$9 - $130	10%
Welmark Mcr Adv	$9 - $130	10%
Wellmark Hmo - All Other Plans	$61	69%
Quartz Comm - All Other Plans	$65 - $226	73%
Wellmark Ppo	$67	75%
Amerigroup Mcaid - All Other Plans	$89 - $296	100%
Iowa Total Care Mcr Adv	$130	146%
Medica Mcr Adv	$130	146%
UnitedHealthcare	$130 - $257	146%
Iowa Total Care Mcaid - All Other Plans	$154 - $296	173%
Molina Mcaid - All Other Plans	$154 - $296	173%
Medica Comm - All Other Plans	$277	312%

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 $170.
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 Veterans 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.