CMS Price Transparency Data

X-ray, shoulder

Facility: Mc Donough District Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $54
  • Cash Discount Price: $177
  • vs. Medicare Baseline: 0.61x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mc Donough District Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.61x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$177

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $177 (199%)
Insurance Median: $54 (61%)
Cash: $177 (199% of Medicare)
Ins. Median: $54 (61% 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.

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
Health Alliance $5 - $471 6%
Hfn $8 - $476 9%
UnitedHealthcare $8 - $476 9%
Aetna $9 - $529 10%
Humana $9 - $476 10%
Medicaid / KanCare $9 - $529 10%
Medicare (plans) $9 - $98 10%
Meridian $9 - $98 10%
Molina $9 - $529 10%
Mutual Medical $9 - $529 10%
Veteran Affairs $9 - $98 10%
Springfield Health $49 - $434 55%
Consociate $51 - $450 57%
Trilogy $51 - $450 57%
Blue Choice $54 - $476 61%
Current Health $54 - $476 61%
Healthlink $54 - $497 61%
Preferred Plan $57 - $503 64%
Blue Cross Blue Shield $60 - $529 67%
Tricare $92 103%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals