CMS Price Transparency Data

X-ray, hip

Facility: HSHS St Elizabeth's Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73502
  • Insurance Median: $246
  • Cash Discount Price: $288
  • vs. Medicare Baseline: 2.77x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at HSHS St Elizabeth's Hospital is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $288. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.77x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$288

Average discount available for prompt cash payment at this facility.

Insurance Median
$246

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: $288 (324%)
Insurance Median: $246 (277%)
Cash: $288 (324% of Medicare)
Ins. Median: $246 (277% 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 277% of the Medicare baseline (a markup of 177%). 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
Aetna $37 - $282 42%
Blue Cross Blue Shield $37 - $400 42%
Claim Doc $37 - $246 42%
Clear Spring Health Of Illinois $37 - $98 42%
Health Alliance Medical Plans $37 - $340 42%
Health Partners $37 - $98 42%
Hopetrust $37 - $236 42%
Humana $37 - $98 42%
Molina Healthcare $37 - $103 42%
Naphcare $37 - $213 42%
Sae Hospice $37 - $98 42%
UnitedHealthcare $37 - $400 42%
Meridian Health Plan $54 - $80 61%
Amish Community $112 126%
Celtic Insurance Company $196 220%
Wellfirst $258 290%
First Health $298 335%
Cigna $316 - $400 355%
Healthlink $318 - $400 358%
Caterpillar, Inc. $321 361%
Consociate Group $352 396%
Choicecare $360 405%
Healthcare Finest Network (Hfn) $360 405%
Multiplan/Phcs $360 405%
Provider Network Of America $360 405%
City Of Springfield $400 450%
Current Health Solutions $400 450%
Healthscope $400 450%
Illinois Breast And Cervical Cancer Program $400 450%
Interplan $400 450%
Live360 $400 450%
Wexford $400 450%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals