X-ray, shoulder
Facility: Oakleaf Surgical Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $86
- Cash Discount Price: $291
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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
For a shoulder X-ray (CPT 73030) at Oakleaf Surgical Hospital in Altoona, WI, the cash median price is $291, which is significantly lower than the facility's gross charge of $324 and the Medicare benchmark of $88.91. While the facility's negotiated rate for in-network payers averages $86, the cash price remains the most transparent figure for patients, especially those with high-deductible plans where paying out-of-pocket upfront may be more cost-effective than facing a negotiated rate that could exceed the cash price depending on specific plan structures.
The data indicates that 11 payers have negotiated rates for this service, with most settling at $86, though Security Health Plan Of Wi and Alliance have distinct rates of $876 and $216 respectively. Although the facility is owned by physicians and rated as an acute care hospital, specific state or county average comparisons for this exact procedure are not provided in the current dataset. Consumers should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can further reduce the final cost, and they should request an itemized bill to ensure no unbundled charges or services not rendered are included.