CMS Price Transparency Data

X-ray, hand

Facility: Sanford Hillsboro

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73130
  • Insurance Median: $224
  • Cash Discount Price: $217
  • vs. Medicare Baseline: 2.52x Medicare
The contracted insurance negotiated median rate for a X-ray, hand at Sanford Hillsboro is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $217. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.52x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.
Cash / Self-Pay
$217

Average discount available for prompt cash payment at this facility.

Insurance Median
$224

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: $217 (244%)
Insurance Median: $224 (252%)
Cash: $217 (244% of Medicare)
Ins. Median: $224 (252% 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 252% of the Medicare baseline (a markup of 152%). 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
Blue Cross Blue Shield $66 - $251 74%
Sanford Health Plan Align $124 139%
Ucare $133 - $238 150%
Aetna $134 - $236 151%
Health Partners $134 - $211 151%
Medicare (plans) $134 151%
UnitedHealthcare $134 - $226 151%
Primewest $137 154%
Security Health Plan $149 168%
Sanford Health Plan $214 - $252 241%
Medica $224 - $239 252%
First Choice Health Network $244 274%
Healthez $244 274%
Multiplan $244 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 Third Street Se, Hillsboro, ND 58045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals