CMS Price Transparency Data

X-ray, shoulder

Facility: Jacksonville Memorial Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $341
Cash Discount Price: $620
vs. Medicare Baseline: 3.84x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Jacksonville Memorial Hospital is $341. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $620. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.84x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$620

Average discount available for prompt cash payment at this facility.

Insurance Median

$341

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: $620 (697%)

Insurance Median: $341 (384%)

Cash: $620 (697% of Medicare)

Ins. Median: $341 (384% 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 384% of the Medicare baseline (a markup of 284%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$31 - $620	35%
Tricare	$32 - $113	36%
Coventry	$33 - $98	37%
Health Alliance	$33 - $422	37%
Humana	$33 - $529	37%
Medicare (plans)	$33 - $98	37%
UnitedHealthcare	$35 - $446	39%
Medicaid / KanCare	$110	124%
Molina Healthcare	$110	124%
Corvel/Corcare	$113 - $174	127%
Illinois Workers Compensation	$121 - $233	136%
Commercial Workers Compensation	$222	250%
Health Alliance Mh Employee Plan	$285	321%
Current Health Network	$341 - $465	384%
6 Degrees Health	$372	418%
Hope Trust	$372	418%
Hst	$372	418%
Cigna	$430	484%
Aetna	$433 - $496	487%
Healthlink	$527	593%
Phcs/Multiplan	$558	628%
Hfn	$589	662%
Liability	$620	697%

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 $620.
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 Jacksonville Memorial Hospital 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.