CMS Price Transparency Data

X-ray, shoulder

Facility: Monroe County Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $103
Cash Discount Price: $125
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Monroe County Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.16x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $125 (141%)

Insurance Median: $103 (116%)

Cash: $125 (141% of Medicare)

Ins. Median: $103 (116% 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
Wellmark Hmo	$73	82%
Wellmark Ppo - All Other Plans	$78	88%
Mahp Mcare - All Plans	$88	99%
Tricare	$88	99%
UnitedHealthcare	$88 - $199	99%
Va Ccn - All Plans	$88	99%
Amerigroup Mcare	$89	100%
Humana	$89	100%
Wellmark Mcare	$89	100%
Aetna	$90 - $196	101%
Iowa Total Care Mcaid - All Plans	$104	117%
Molina Mcaid - All Plans	$106	119%
Amerigroup Mcaid - All Other Plans	$108	121%
Centivo - All Plans	$132	148%
Midlands Choice - All Plans	$146	164%
Preferred Hlth - All Plans	$157	177%
Geha - All Plans	$167	188%
Multiplan - All Plans	$188	211%
Integrated Hp - All Plans	$203	228%

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 $125.
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 Monroe County 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.