CMS Price Transparency Data

X-ray, hip

Facility: Hermann Area District Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $222
Cash Discount Price: $249
vs. Medicare Baseline: 2.50x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Hermann Area District Hospital is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.50x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$249

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: $249 (280%)

Insurance Median: $222 (250%)

Cash: $249 (280% 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.

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
Healthy Blue Mcaid - All Plans	$31	35%
Ambetter / Centene	$32 - $344	36%
Blue Cross Blue Shield	$33 - $397	37%
UnitedHealthcare	$33 - $292	37%
Tricare	$135 - $193	152%
Choicecare Mcr Adv- All Plans	$143 - $205	161%
American Hlth Mcr Adv- All Plans	$150 - $215	169%
Humana	$150 - $215	169%
Aetna	$153 - $464	172%
Wellcare Mcr Adv - All Plans	$153 - $219	172%
Cigna	$186 - $266	209%
Harmony Hp Mcaid- All Plans	$198 - $283	223%
Care Partners Mcaid- All Plans	$205 - $293	231%
Healthcare Usa Mcaid- All Plans	$222 - $317	250%
Healthlink Hmo	$222 - $317	250%
Healthlink Ppo - All Other Plans	$256 - $366	288%
Multiplan/Phcs - All Plans	$256 - $366	288%
Coventry - All Plans	$290 - $415	326%
Comp Results - All Plans	$307 - $439	345%
Three Rivers - All Plans	$307 - $439	345%

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 $249.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hermann Area District Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73502.
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.