CMS Price Transparency Data

X-ray, shoulder

Facility: Essentia Health Virginia

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $195
  • Cash Discount Price: $210
  • vs. Medicare Baseline: 2.19x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Essentia Health Virginia is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.19x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.
Cash / Self-Pay
$210

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $210 (236%)
Insurance Median: $195 (219%)
Cash: $210 (236% of Medicare)
Ins. Median: $195 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Medica Access $77 87%
Advocare/Security Health $86 97%
Blue Cross Blue Shield $86 - $323 97%
Freedom Blue Ppo $86 97%
Healthpartners Care Msho / Mcr Adv $86 97%
Imcare Msho Pcc Prime $86 97%
Imcare Msho Ref Req $86 97%
Medica Advantage Solutions $86 97%
Medica Msho/Dual Solutions $86 97%
Medica Prime Solution Group $86 97%
Medicare (plans) $86 97%
Nd Va Administration $86 97%
Platinum Blue/Vantage Blue $86 97%
Primewest Msho $86 97%
Secure Blue Msho $86 97%
Ubh Cost Plan $86 97%
Ubh Msho $86 97%
Ucare Msho $86 97%
UnitedHealthcare $86 - $295 97%
Itasca Med Care $88 99%
Primewest $88 99%
Healthpartners Care Pmap $133 150%
Sanford Healthplan $144 - $156 162%
Blue Plus Pmap Pcc Prime $157 - $225 177%
Medica $213 - $237 240%
Medica Uplan $213 240%
Ucare $220 247%
Healthpartners $239 - $303 269%
Wea $241 - $258 271%
Medica Choice $244 274%
Security Health $258 290%
America'S Ppo $260 292%
Wps $278 - $281 313%
Aetna $285 321%
Cigna $302 - $303 340%
Healthpartners Pcc Prime $302 - $303 340%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 9Th Street North, Virginia, MN 55792
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals