CMS Price Transparency Data

X-ray, shoulder

Facility: Marshfield Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $419
Cash Discount Price: $437
vs. Medicare Baseline: 4.71x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Marshfield Medical Center is $419. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $437. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.71x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$437

Average discount available for prompt cash payment at this facility.

Insurance Median

$419

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: $437 (492%)

Insurance Median: $419 (471%)

Cash: $437 (492% of Medicare)

Ins. Median: $419 (471% 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 471% of the Medicare baseline (a markup of 371%). 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
Security Health Plan (Shp)	$133 - $183	150%
Blue Cross Blue Shield	$177 - $201	199%
Family Health Center (Fhc)	$230	259%
Amish/Mennonite	$253	285%
Sanford Health Plan	$253	285%
The Alliance	$320 - $384	360%
Group Health Cooperative Of Eau Claire	$377 - $423	424%
Besse Forest Products	$391	440%
Molina Healthcare Of Wi	$391	440%
Rice Lake School District	$391	440%
Wps Health Insurance	$406 - $444	457%
Trilogy	$414 - $442	466%
Medica Of Wi	$427 - $436	480%
Cigna	$432	486%
Healtheos By Multiplan Inc.	$432 - $437	486%
Corvel	$437	492%
First Health	$437	492%
Health Partners	$437	492%
Three Rivers Provider Network (Trpn)	$437	492%
Coventry	$442	497%
Health Smart	$442	497%
Rising Medical Work Comp	$446	502%
UnitedHealthcare	$484	544%

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 $437.
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 Marshfield Medical Center 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.