CMS Price Transparency Data

X-ray, shoulder

Facility: Essentia Health St Marys - Detroit Lakes

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $168
Cash Discount Price: $227
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Essentia Health St Marys - Detroit Lakes is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.89x the Medicare baseline. Located in 1027 Washington Ave, Detroit Lakes, MN.

Cash / Self-Pay

$227

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $227 (255%)

Insurance Median: $168 (189%)

Cash: $227 (255% of Medicare)

Ins. Median: $168 (189% 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
Blue Cross Blue Shield	$61 - $400	69%
Itasca Med Care	$88	99%
Primewest	$88	99%
Advocare/Security Health	$93	105%
Freedom Blue Ppo	$93	105%
Healthpartners Care Msho / Mcr Adv	$93	105%
Imcare Msho Pcc Prime	$93	105%
Imcare Msho Ref Req	$93	105%
Medica Advantage Solutions	$93	105%
Medica Msho/Dual Solutions	$93	105%
Medica Prime Solution Group	$93	105%
Medicare (plans)	$93	105%
Nd Va Administration	$93	105%
Platinum Blue/Vantage Blue	$93	105%
Primewest Msho	$93	105%
Secure Blue Msho	$93	105%
Ubh Cost Plan	$93	105%
Ubh Msho	$93	105%
Ucare Msho	$93	105%
UnitedHealthcare	$93 - $297	105%
Healthpartners Care Pmap	$137	154%
Sanford Healthplan	$151 - $159	170%
Medica Uplan	$225	253%
Ucare	$232	261%
Healthpartners	$237 - $259	267%
Medica	$246 - $274	277%
Wea	$254 - $272	286%
Cigna	$259	291%
Healthpartners Pcc Prime	$259	291%
America'S Ppo	$274	308%
Medica Choice	$282	317%
Wps	$293 - $297	330%
Aetna	$300	337%
Healtheos	$304	342%

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 $227.
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 Essentia Health St Marys - Detroit Lakes 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.