CMS Price Transparency Data

X-ray, hand

Facility: Holy Family Memorial

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $264
Cash Discount Price: $211
vs. Medicare Baseline: 2.97x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Holy Family Memorial is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.97x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.

Cash / Self-Pay

$211

Average discount available for prompt cash payment at this facility.

Insurance Median

$264

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: $211 (237%)

Insurance Median: $264 (297%)

Cash: $211 (237% of Medicare)

Ins. Median: $264 (297% 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 297% of the Medicare baseline (a markup of 197%). 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
Blue Cross Blue Shield	$48 - $84	54%
Community Care Incorporated	$84	94%
Health Partners	$84 - $249	94%
Humana	$84	94%
Icare	$84	94%
Molina	$84 - $90	94%
Network Health Plan	$84 - $399	94%
Security Health Plan	$84 - $306	94%
UnitedHealthcare	$84 - $597	94%
Allwell	$85	96%
Medical College Of Wisconsin	$126	142%
Centivo	$153 - $176	172%
Dean Health Plan	$192	216%
Sheboygan Employers Health Network	$230	259%
Health Payment Systems	$244	274%
Chorus Community Health Plan	$246	277%
Trilogy	$253	285%
Cigna	$276	310%
Wps Health Plan	$283	318%
Aspirus	$306	344%
Healtheos	$306	344%
Multiplan/Private Healthcare Systems	$306	344%
Preferred One	$306	344%
Healthsmart	$318	358%
First Health Network	$337	379%

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 $211.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holy Family Memorial is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
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.