CMS Price Transparency Data

X-ray, shoulder

Facility: Sanford Wheaton Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $373
  • Cash Discount Price: $350
  • vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Sanford Wheaton Medical Center is $373. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $350. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.20x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.
Cash / Self-Pay
$350

Average discount available for prompt cash payment at this facility.

Insurance Median
$373

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: $350 (394%)
Insurance Median: $373 (420%)
Cash: $350 (394% of Medicare)
Ins. Median: $373 (420% 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 420% of the Medicare baseline (a markup of 320%). 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
Ucare $92 - $385 103%
Blue Cross Blue Shield $106 - $405 119%
Sanford Health Plan Align $221 249%
Aetna $239 - $381 269%
Health Partners $239 - $355 269%
Medicare (plans) $239 269%
UnitedHealthcare $239 - $366 269%
Security Health Plan $241 271%
Primewest $244 - $265 274%
Sanford Health Plan $346 - $407 389%
Medica $385 - $414 433%
First Choice Health Network $394 443%
Healthez $394 443%
Multiplan $394 443%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 12Th Street North, Wheaton, MN 56296
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals