CMS Price Transparency Data

X-ray, shoulder

Facility: Mercy Medical Center-New Hampton

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $374
  • Cash Discount Price: $322
  • vs. Medicare Baseline: 4.21x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy Medical Center-New Hampton is $374. 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 4.21x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$322

Average discount available for prompt cash payment at this facility.

Insurance Median
$374

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: $374 (421%)
Cash: $322 (362% of Medicare)
Ins. Median: $374 (421% 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 421% of the Medicare baseline (a markup of 321%). 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 $157 - $235 177%
Aetna $158 - $561 178%
Medicare (plans) $160 - $265 180%
UnitedHealthcare $168 - $356 189%
Health Choices $200 - $300 225%
Medical Associates $200 - $300 225%
Amish Hospital Aid $211 - $316 237%
Oscar $233 - $349 262%
Geha $238 - $356 268%
Ambetter / Centene $266 - $399 299%
Iowa Total Care $271 - $406 305%
Medicaid / KanCare $275 - $414 309%
Claimdoc $318 - $478 358%
Nova $318 - $478 358%
1199 National Benefit Fund $374 - $561 421%
Allied Benefit Systems $374 - $561 421%
Asr Health Benefits $374 - $561 421%
Coventry $374 - $561 421%
First Health $374 - $561 421%
Lucent Health $374 - $561 421%
Luminare Health $374 - $561 421%
Medical Mutual $374 - $561 421%
Meritain $374 - $561 421%
Trustmark Small Business Benefits $374 - $561 421%
Webtpa $374 - $561 421%
First Choice Health $376 - $564 423%
Health Partners $381 - $571 429%
Auxiant $384 - $576 432%
Cigna $384 - $576 432%
Medica $384 - $576 432%
Midlands $384 - $576 432%
Midlands Choice $384 - $576 432%
Crime Victim Assistance $396 - $594 445%
Iowa Dept Of Public Health $396 - $594 445%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 308 North Maple Avenue, New Hampton, IA 50659
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals