CMS Price Transparency Data

X-ray, foot

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $332
  • Cash Discount Price: $257
  • vs. Medicare Baseline: 3.73x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Gundersen St Josephs Hospital and Clinics is $332. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.73x the Medicare baseline. Located in 400 Water Ave, Hillsboro, WI.
Cash / Self-Pay
$257

Average discount available for prompt cash payment at this facility.

Insurance Median
$332

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: $257 (289%)
Insurance Median: $332 (373%)
Cash: $257 (289% of Medicare)
Ins. Median: $332 (373% 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 373% of the Medicare baseline (a markup of 273%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Amerigroup $24 27%
Security Health Plan $87 98%
Blue Cross Blue Shield $147 - $443 165%
Iowa Total Care $147 165%
Managed Health Service $147 165%
Ucare $230 - $354 259%
UnitedHealthcare $235 - $310 264%
Quartz $241 271%
Alliance $354 - $1,529 398%
Cigna $363 408%
Aspirus Arise Health $368 414%
Humana $377 424%
Multiplan/Healtheos $385 - $421 433%
Coventry Health Care $421 474%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 Water Ave, Hillsboro, WI 54634
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals