CMS Price Transparency Data

X-ray, hip

Facility: St Joseph's Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73502
  • Insurance Median: $215
  • Cash Discount Price: $221
  • vs. Medicare Baseline: 2.42x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at St Joseph's Hospital is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $221. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.42x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$221

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $221 (249%)
Insurance Median: $215 (242%)
Cash: $221 (249% of Medicare)
Ins. Median: $215 (242% 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 242% of the Medicare baseline (a markup of 142%). 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 $61 - $215 69%
Humana $61 69%
Sae Hospice $61 69%
Clear Spring Health of Illinois $61 69%
Molina Healthcare $61 - $170 69%
Blue Cross Blue Shield $61 69%
UnitedHealthcare $61 - $307 69%
Amish Community $86 97%
Cigna $98 110%
Meridian Health Plan $119 - $178 134%
Naphcare $129 145%
Celtic Insurance Company $135 152%
Claim Doc $154 173%
Hopetrust $154 173%
Wellfirst $197 222%
First Health $227 255%
Multiplan/Phcs $261 294%
Healthlink $261 294%
Provider Network of America $276 310%
Healthcare Finest Network (Hfn) $276 310%
Interplan $307 345%
Caterpillar, Inc. $307 345%
Illinois Breast and Cervical Cancer Program $307 345%
Mental Health Network $307 345%
Healthscope $307 345%
Current Health Solutions $307 345%
Health Alliance Medical Plans $307 345%
Qtc Medical Group of Illinois $307 345%
Consociate Group $307 345%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals