CMS Price Transparency Data

X-ray, shoulder

Facility: HSHS St Elizabeth's Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $652
  • Cash Discount Price: $590
  • vs. Medicare Baseline: 7.33x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at HSHS St Elizabeth's Hospital is $652. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $590. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.33x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$590

Average discount available for prompt cash payment at this facility.

Insurance Median
$652

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: $590 (664%)
Insurance Median: $652 (733%)
Cash: $590 (664% of Medicare)
Ins. Median: $652 (733% 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 733% of the Medicare baseline (a markup of 633%). 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
Molina Healthcare $51 - $103 57%
Meridian Health Plan $54 - $80 61%
Aetna $98 - $577 110%
Blue Cross Blue Shield $98 - $820 110%
Clear Spring Health Of Illinois $98 110%
Health Alliance Medical Plans $98 - $697 110%
Health Partners $98 110%
Humana $98 110%
Sae Hospice $98 110%
UnitedHealthcare $98 - $820 110%
Celtic Insurance Company $196 220%
Naphcare $213 240%
Amish Community $230 259%
Hopetrust $236 265%
Claim Doc $246 277%
Wellfirst $528 594%
First Health $610 686%
Cigna $648 - $820 729%
Healthlink $652 - $820 733%
Caterpillar, Inc. $658 740%
Consociate Group $722 812%
Choicecare $738 830%
Healthcare Finest Network (Hfn) $738 830%
Multiplan/Phcs $738 830%
Provider Network Of America $738 830%
City Of Springfield $820 922%
Current Health Solutions $820 922%
Healthscope $820 922%
Illinois Breast And Cervical Cancer Program $820 922%
Interplan $820 922%
Live360 $820 922%
Wexford $820 922%

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