CMS Price Transparency Data

X-ray, shoulder

Facility: Boone County Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $44
Cash Discount Price: $164
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Boone County Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.49x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$164

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $164 (184%)

Insurance Median: $44 (49%)

Cash: $164 (184% of Medicare)

Ins. Median: $44 (49% 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	$16 - $548	18%
Amerigroup Mcr Adv - All Other Plans	$16 - $291	18%
Choice Care Mcr Adv - All Plans	$16 - $288	18%
Humana	$16 - $633	18%
Iowa Hlth Adv - All Plans	$16 - $288	18%
Mt Carmel Hp - All Plans	$16 - $288	18%
UnitedHealthcare	$16 - $413	18%
Va Ccn-All Plans	$16 - $288	18%
Iowa Total Care Mcaid - All Plans	$18 - $323	20%
Medicaid / KanCare	$18 - $326	20%
Meridian Mcaid - All Plans	$18 - $316	20%
Healthsmart Accell Network	$27 - $492	30%
Medical Associates Hp-All Plans	$29 - $527	33%
Healthsmart Ppo - All Other Plans	$31 - $562	35%
Health Alliance-All Plans	$35 - $633	39%
Midlands Choice-All Plans	$36 - $647	40%
Mutually Preferred-All Plans	$37 - $668	42%
Wellmark Hmo	$58	65%
Wellmark Ppo - All Other Plans	$64	72%
Tricare	$89	100%

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 $164.
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 Boone 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.