CMS Price Transparency Data

X-ray, shoulder

Facility: Northwestern Medicine McHenry

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $445
Cash Discount Price: $623
vs. Medicare Baseline: 5.01x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Northwestern Medicine McHenry is $445. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $623. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.01x the Medicare baseline. Located in 4201 Medical Center Drive, McHenry, IL.

Cash / Self-Pay

$623

Average discount available for prompt cash payment at this facility.

Insurance Median

$445

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: $623 (701%)

Insurance Median: $445 (501%)

Cash: $623 (701% of Medicare)

Ins. Median: $445 (501% 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 501% of the Medicare baseline (a markup of 401%). 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
Aetna	$172 - $467	193%
Mercy Care Health Plans [5013]	$270	304%
Blue Cross Blue Shield	$302 - $890	340%
Healthlink [125]	$445	501%
Choicecare [177]	$473	532%
Multiplan/Phcs [142]	$561 - $890	631%
The Alliance [1703]	$572	643%
Health'S Finest Network [126]	$623 - $650	701%
Cigna	$668	751%
Beechstreet [176]	$712	801%

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 $623.
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 Northwestern Medicine McHenry 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.