CMS Price Transparency Data

X-ray, shoulder

Facility: UW Health

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $48
Cash Discount Price: $32
vs. Medicare Baseline: 0.54x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at UW Health is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.54x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

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: $32 (36%)

Insurance Median: $48 (54%)

Cash: $32 (36% of Medicare)

Ins. Median: $48 (54% 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.

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	$11 - $807	12%
Blue Cross Blue Shield	$11 - $553	12%
Medicaid / KanCare	$11 - $23	12%
UnitedHealthcare	$20 - $860	22%
Hfn	$22 - $880	25%
Ecoh	$25 - $880	28%
Humana	$25 - $133	28%
Medicare (plans)	$25 - $147	28%
Mychoice Wi Medical Adv	$25 - $133	28%
Quartz Aso	$29 - $611	33%
Quartz Fully Insured	$29 - $388	33%
Cigna	$39 - $893	44%
Alliance Premier Network	$51 - $610	57%
The Alliance	$56 - $786	63%
Wps	$74 - $101	83%
Workers Comp	$79 - $136	89%
Beloit Healt System	$86 - $1,009	97%
Mercy Care	$103 - $142	116%
Wps Ppo	$432 - $865	486%
Mercycare	$522 - $1,044	587%
First Health/Coventry	$550 - $1,100	619%
Health Payment Systems	$652 - $1,305	733%
Healthsmart	$652 - $1,305	733%
Sheboygan Employers Health Network	$696 - $1,392	783%
Multiplan	$778 - $1,556	875%

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 $32.
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 UW Health 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.