CMS Price Transparency Data

X-ray, shoulder

Facility: Holy Family Memorial

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $160
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Holy Family Memorial is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.80x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$160

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: $122 (137%)
Insurance Median: $160 (180%)
Cash: $122 (137% of Medicare)
Ins. Median: $160 (180% 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.

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 $43 - $84 48%
Medical College Of Wisconsin $73 82%
Community Care Incorporated $84 94%
Health Partners $84 - $144 94%
Humana $84 94%
Icare $84 94%
Molina $84 - $90 94%
Network Health Plan $84 - $399 94%
Security Health Plan $84 - $178 94%
UnitedHealthcare $84 - $597 94%
Allwell $85 96%
Centivo $89 - $102 100%
Dean Health Plan $111 125%
Sheboygan Employers Health Network $133 150%
Chorus Community Health Plan $143 161%
Trilogy $147 165%
Cigna $160 180%
Wps Health Plan $164 184%
Aspirus $178 200%
Healtheos $178 200%
Multiplan/Private Healthcare Systems $178 200%
Preferred One $178 200%
Healthsmart $184 207%
First Health Network $195 219%
Health Payment Systems $244 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals