CMS Price Transparency Data

X-ray, shoulder

Facility: Marshfield Medical Center - Weston

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $241
Cash Discount Price: $255
vs. Medicare Baseline: 2.71x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Marshfield Medical Center - Weston is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.71x the Medicare baseline. Located in 3400 Ministry Parkway, Weston, WI.

Cash / Self-Pay

$255

Average discount available for prompt cash payment at this facility.

Insurance Median

$241

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: $255 (287%)

Insurance Median: $241 (271%)

Cash: $255 (287% of Medicare)

Ins. Median: $241 (271% 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 271% of the Medicare baseline (a markup of 171%). 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
Security Health Plan (Shp)	$133 - $183	150%
Family Health Center (Fhc)	$134	151%
Amish/Mennonite	$147	165%
Sanford Health Plan	$147	165%
The Alliance	$163 - $1,292	183%
Blue Cross Blue Shield	$177 - $201	199%
Group Health Cooperative Of Eau Claire	$220 - $241	247%
UnitedHealthcare	$221	249%
Besse Forest Products	$228	256%
Molina Healthcare Of Wi	$228	256%
Rice Lake School District	$228	256%
Wps Health Insurance	$237 - $259	267%
Medica Of Wi	$250 - $255	281%
Cigna	$252	283%
Healtheos By Multiplan Inc.	$252 - $255	283%
Corvel	$255	287%
First Health	$255	287%
Health Partners	$255	287%
Three Rivers Provider Network (Trpn)	$255	287%
Trilogy	$256 - $257	288%
Coventry	$257	289%
Health Smart	$257	289%
Rising Medical Work Comp	$260	292%

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 $255.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73030.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Marshfield Medical Center - Weston is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73030.
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.