CMS Price Transparency Data

X-ray, shoulder

Facility: Madison County Health Care System

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $166
  • Cash Discount Price: $263
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Madison County Health Care System is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $263. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.87x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$263

Average discount available for prompt cash payment at this facility.

Insurance Median
$166

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: $263 (296%)
Insurance Median: $166 (187%)
Cash: $263 (296% of Medicare)
Ins. Median: $166 (187% 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.

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 $9 - $251 10%
American Hp Mcr Adv-All Plans $9 - $174 10%
Choicecare-All Plans $9 - $367 10%
Medical Associates Hp - All Plans $9 - $166 10%
Medigold-All Plans $9 - $166 10%
Medimore Employee Hp - All Plans $9 - $378 10%
Tricare $9 - $166 10%
UnitedHealthcare $9 - $347 10%
Oscar - All Plans $14 - $249 16%
Blue Cross Blue Shield $18 - $65 20%
Midlands Choice - All Plans $19 - $378 21%
Madison County Sheriff-All Plans $61 - $193 69%
Corvel Wc-All Plans $110 - $347 124%
First Choice-All Plans $116 - $367 130%
First Health-All Plans $116 - $367 130%
Integrated Hp-All Plans $116 - $367 130%
Mutual Of Omaha-All Plans $116 - $367 130%
Plaines Health-All Plans $116 - $367 130%
Preferred Hlth Ntwork-All Plans $116 - $367 130%
Principal Healthcare-All Plans $116 - $367 130%
Usa Managed Care-All Plans $116 - $367 130%
Benefit Admin Of America-All Plans $122 - $386 137%
Iowa Total Care Mcaid-All Plans $122 - $181 137%
Molina Mcaid/Chip -All Plans $125 - $188 141%
Amerigroup Mcaid-All Plans $129 - $192 145%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals