CMS Price Transparency Data

X-ray, shoulder

Facility: Mercyone Elkader Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $379
  • Cash Discount Price: $322
  • vs. Medicare Baseline: 4.26x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercyone Elkader Medical Center is $379. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $322. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.26x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$322

Average discount available for prompt cash payment at this facility.

Insurance Median
$379

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: $322 (362%)
Insurance Median: $379 (426%)
Cash: $322 (362% of Medicare)
Ins. Median: $379 (426% 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 426% of the Medicare baseline (a markup of 326%). 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
Blue Cross Blue Shield $204 - $306 229%
Aetna $206 - $437 232%
Medicare (plans) $208 - $321 234%
UnitedHealthcare $218 - $446 245%
Iowa Total Care $246 - $370 277%
Medicaid / KanCare $250 - $377 281%
Amish Hospital Aid $274 - $411 308%
1199 National Benefit Fund $291 - $437 327%
Allied Benefit Systems $291 - $437 327%
Asr Health Benefits $291 - $437 327%
Christian Brother Services $291 - $437 327%
Coventry $291 - $437 327%
First Health $291 - $437 327%
Lucent Health $291 - $437 327%
Luminare Health $291 - $437 327%
Medical Mutual $291 - $437 327%
Meritain $291 - $437 327%
Trustmark Small Business Benefits $291 - $437 327%
Webtpa $291 - $437 327%
Geha $297 - $446 334%
Centivo $309 - $463 348%
Health Choices $317 - $475 357%
Medical Associates $317 - $475 357%
Ambetter / Centene $346 - $519 389%
Health Partners $381 - $571 429%
Auxiant $388 - $582 436%
Cigna $388 - $582 436%
Medica $388 - $582 436%
Midlands $388 - $582 436%
Midlands Choice $388 - $582 436%
Crime Victim Assistance $396 - $594 445%
Iowa Dept Of Public Health $396 - $594 445%
Claimdoc $414 - $621 466%
Nova $414 - $621 466%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals