CMS Price Transparency Data

X-ray, shoulder

Facility: Kossuth Regional Health Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $241
Cash Discount Price: $244
vs. Medicare Baseline: 2.71x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Kossuth Regional Health Center is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.71x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.

Cash / Self-Pay

$244

Average discount available for prompt cash payment at this facility.

Insurance Median

$241

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: $244 (274%)

Insurance Median: $241 (271%)

Cash: $244 (274% of Medicare)

Ins. Median: $241 (271% 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 271% of the Medicare baseline (a markup of 171%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$69 - $76	78%
Mercy One - All Plans	$108 - $124	121%
Va Ccn - All Plans	$108 - $124	121%
Humana	$109 - $125	123%
Amerigroup Mcr Adv - All Other Plans	$110 - $126	124%
UnitedHealthcare	$111 - $247	125%
Health Partners New Bus - All Other Plans	$199 - $228	224%
Midlands Choice - All Plans	$199 - $228	224%
Medical Associates - All Plans	$241 - $276	271%
Preferred Health - All Plans	$241 - $276	271%
Aetna	$264 - $315	297%
Multiplan - All Plans	$270 - $309	304%
Health Partners Exisiting Bus	$275 - $315	309%
Molina Mcaid/Chip - All Plans	$293 - $335	330%
Amerigroup Mcaid	$295 - $338	332%

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 $244.
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 Kossuth Regional Health Center 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.