CMS Price Transparency Data

X-ray, hip

Facility: St Josephs Community Hospital West Bend

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73502
  • Insurance Median: $495
  • Cash Discount Price: $424
  • vs. Medicare Baseline: 5.57x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at St Josephs Community Hospital West Bend is $495. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $424. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.57x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$424

Average discount available for prompt cash payment at this facility.

Insurance Median
$495

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: $424 (477%)
Insurance Median: $495 (557%)
Cash: $424 (477% of Medicare)
Ins. Median: $495 (557% 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 557% of the Medicare baseline (a markup of 457%). 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 $61 - $654 69%
Allwell $86 97%
Community Care $86 97%
Health Partners $86 - $500 97%
Humana $86 97%
Icare $86 97%
Molina $86 97%
Network Health Plan $86 - $399 97%
Security Health Plan Secure Savers $86 97%
UnitedHealthcare $86 - $597 97%
Aetna $87 - $539 98%
Care Wisconsin $88 99%
Centivo $231 - $254 260%
Froedtert South $323 363%
Chorus Community Health Plan $331 372%
Sheboygan Employers Health Network $426 479%
Common Ground $462 520%
Health Payment Systems $485 - $622 545%
Wisconsin Physician Services $616 693%
Trilogy $631 710%
Americas Choice $670 754%
Healtheos $670 754%
Multiplan/Private Healthcare Systems $670 754%
First Health Network $678 763%
Hfn $693 779%
Ibsi Passport $693 779%
Cigna $732 823%
Healthsmart $732 823%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals