CMS Price Transparency Data

X-ray, hand

Facility: Hamilton Memorial Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $152
Cash Discount Price: $168
vs. Medicare Baseline: 1.71x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Hamilton Memorial Hospital is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.71x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $168 (189%)

Insurance Median: $152 (171%)

Cash: $168 (189% of Medicare)

Ins. Median: $152 (171% 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	$36 - $178	40%
Blue Cross Blue Shield	$36 - $180	40%
Health Alliance	$36 - $158	40%
Medicare (plans)	$36 - $79	40%
UnitedHealthcare	$36 - $141	40%
Wellcare	$36 - $79	40%
Medicaid / KanCare	$73 - $79	82%
Humana	$79	89%
Alliance Coal	$138	155%
Healthscope	$138	155%
Wellfirst (Ssmhic)	$138	155%
Hope Trust	$148	166%
Cigna	$155	174%
Hfn, Inc	$158 - $178	178%
Healthlink	$168 - $178	189%
Multiplan	$168	189%
Siho	$178	200%
Three Rivers Provider	$178	200%
Healthsmart	$188	211%
Stratose	$188	211%

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 $168.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hamilton Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
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.