CMS Price Transparency Data

X-ray, shoulder

Facility: Sanford Sheldon Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $291
  • Cash Discount Price: $361
  • vs. Medicare Baseline: 3.27x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Sanford Sheldon Medical Center is $291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $361. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.27x the Medicare baseline. Located in 118 North Seventh Avenue, Po Box 250, Sheldon, IA.
Cash / Self-Pay
$361

Average discount available for prompt cash payment at this facility.

Insurance Median
$291

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: $361 (406%)
Insurance Median: $291 (327%)
Cash: $361 (406% of Medicare)
Ins. Median: $291 (327% 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 327% of the Medicare baseline (a markup of 227%). 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
Sanford Health Plan Align $129 145%
Ucare $138 - $396 155%
Aetna $139 - $392 156%
Blue Cross Blue Shield $139 156%
Health Partners $139 - $338 156%
Medicare (plans) $139 156%
UnitedHealthcare $139 - $377 156%
Primewest $142 160%
Wellmark $226 - $235 254%
Sanford Health Plan $242 - $284 272%
Security Health Plan $248 279%
Medica $372 - $398 418%
First Choice Health Network $406 457%
Healthez $406 457%
Multiplan $406 457%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 118 North Seventh Avenue, Po Box 250, Sheldon, IA 51201
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals