CMS Price Transparency Data

X-ray, hip

Facility: Oakleaf Surgical Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73502
  • Insurance Median: $86
  • Cash Discount Price: $204
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at Oakleaf Surgical Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$204

Average discount available for prompt cash payment at this facility.

Insurance Median
$86

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: $204 (229%)
Insurance Median: $86 (97%)
Cash: $204 (229% of Medicare)
Ins. Median: $86 (97% 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 $86 97%
Dean Health Plan $86 97%
Group Health Cooperative Of Eau Claire $86 97%
Healthpartners $86 97%
Humana $86 97%
Medica $86 97%
Quartz Health Solutions $86 97%
Security Health Plan Of Wi $86 - $876 97%
Ucare Wi $86 97%
UnitedHealthcare $86 97%
Alliance $216 243%

Consumer Guidance & Cost Commentary

Oakleaf Surgical Hospital, located in Altoona, Wisconsin, provides an X-ray of the hip with a cash median price of $204. This cash rate is notably lower than the facility's median negotiated rate of $86 and significantly below the Medicare amount of $88.91. For patients with high-deductible plans, paying the cash price of $204 upfront may result in lower out-of-pocket costs compared to the insurance negotiated rate of $86, provided their deductible has not yet been met. It is important to note that while the facility's ownership is physician-owned and the procedure is billed under CPT code 73502, patients should verify their specific plan details before scheduling to ensure they understand their financial responsibility.

When considering payment options, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill further by bypassing the administrative costs associated with insurance claims processing. Although the data indicates 11 payers with a high-low range of $86 to $876, the cash price remains a viable option for those seeking to avoid balance billing or unexpected charges from out-of-network services. To protect against errors, consumers are advised to request a full itemized billing audit that details every CPT code and unit cost rather than accepting a summary bill, as over 80% of hospital invoices contain discrepancies such as unbundled codes or services not rendered.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals