CMS Price Transparency Data

X-ray, shoulder

Facility: Essentia Health Sandstone

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $222
  • Cash Discount Price: $239
  • vs. Medicare Baseline: 2.50x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Essentia Health Sandstone is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.50x the Medicare baseline. Located in 705 Lundorff Drive South, Sandstone, MN.
Cash / Self-Pay
$239

Average discount available for prompt cash payment at this facility.

Insurance Median
$222

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: $239 (269%)
Insurance Median: $222 (250%)
Cash: $239 (269% of Medicare)
Ins. Median: $222 (250% 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 250% of the Medicare baseline (a markup of 150%). 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
Itasca Med Care $88 99%
Primewest $88 99%
Blue Cross Blue Shield $124 - $260 139%
Blue Plus Pmap Pcc Prime $124 - $178 139%
Medica Access $129 - $202 145%
Healthpartners Care Pmap $130 146%
Sanford Healthplan $139 - $146 156%
Advocare/Security Health $152 171%
Freedom Blue Ppo $152 171%
Healthpartners Care Msho / Mcr Adv $152 171%
Imcare Msho Pcc Prime $152 171%
Imcare Msho Ref Req $152 171%
Medica Advantage Solutions $152 171%
Medica Msho/Dual Solutions $152 171%
Medica Prime Solution Group $152 171%
Medicare (plans) $152 171%
Nd Va Administration $152 171%
Platinum Blue/Vantage Blue $152 171%
Primewest Msho $152 171%
Secure Blue Msho $152 171%
Ubh Cost Plan $152 171%
Ubh Msho $152 171%
Ucare Msho $152 171%
UnitedHealthcare $152 - $295 171%
Ucare $213 240%
Healthpartners $219 - $258 246%
Medica $232 - $258 261%
Medica Uplan $232 261%
Wea $233 - $249 262%
America'S Ppo $251 282%
Cigna $253 - $258 285%
Healthpartners Pcc Prime $253 - $258 285%
Medica Choice $265 298%
Wps $269 - $272 303%
Aetna $275 309%
Security Health $324 364%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 705 Lundorff Drive South, Sandstone, MN 55072
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals