CMS Price Transparency Data

X-ray, hand

Facility: Madison County Health Care System

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $105
Cash Discount Price: $178
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Madison County Health Care System is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.18x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.

Cash / Self-Pay

$178

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $178 (200%)

Insurance Median: $105 (118%)

Cash: $178 (200% of Medicare)

Ins. Median: $105 (118% 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	$8 - $223	9%
Choicecare-All Plans	$8 - $326	9%
Medical Associates Hp - All Plans	$8 - $147	9%
Medigold-All Plans	$8 - $147	9%
Medimore Employee Hp - All Plans	$8 - $336	9%
Tricare	$8 - $147	9%
UnitedHealthcare	$8 - $309	9%
American Hp Mcr Adv-All Plans	$9 - $155	10%
Oscar - All Plans	$14 - $221	16%
Blue Cross Blue Shield	$16 - $65	18%
Midlands Choice - All Plans	$18 - $336	20%
Madison County Sheriff-All Plans	$51 - $172	57%
Corvel Wc-All Plans	$92 - $309	103%
First Choice-All Plans	$97 - $326	109%
First Health-All Plans	$97 - $326	109%
Integrated Hp-All Plans	$97 - $326	109%
Mutual Of Omaha-All Plans	$97 - $326	109%
Plaines Health-All Plans	$97 - $326	109%
Preferred Hlth Ntwork-All Plans	$97 - $326	109%
Principal Healthcare-All Plans	$97 - $326	109%
Usa Managed Care-All Plans	$97 - $326	109%
Benefit Admin Of America-All Plans	$102 - $343	115%
Iowa Total Care Mcaid-All Plans	$102 - $161	115%
Molina Mcaid/Chip -All Plans	$105 - $167	118%
Amerigroup Mcaid-All Plans	$108 - $171	121%

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 $178.
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 Madison County Health Care System 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.