CMS Price Transparency Data

X-ray, hip

Facility: Stoughton Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $239
Cash Discount Price: $295
vs. Medicare Baseline: 2.69x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Stoughton Hospital is $239. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $295. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.69x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.

Cash / Self-Pay

$295

Average discount available for prompt cash payment at this facility.

Insurance Median

$239

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: $295 (332%)

Insurance Median: $239 (269%)

Cash: $295 (332% of Medicare)

Ins. Median: $239 (269% 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 269% of the Medicare baseline (a markup of 169%). 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
Medicaid / KanCare	$67	75%
Quartz Health Solutions - All Other Lans	$77	87%
Tricare	$128	144%
Healthnet Mcr Adv - All Plans	$143	161%
Dean Health Insurance Med Adv	$150	169%
Humana	$150 - $483	169%
Quartz Mcr Adv	$150	169%
Security Health/First Health - All Plans	$150	169%
Aetna	$161 - $456	181%
UnitedHealthcare	$236 - $430	265%
Dean Health Insurance Comm - All Other Plans	$239	269%
Dean Health Insurance Epo	$239	269%
Geha - All Plans	$403	453%
Cigna	$430	484%
Wisconsin Ppo Ppa Direct - All Plans	$430	484%
Blue Cross Blue Shield	$467	525%
Wps - All Plans	$483	543%
Alliance - All Plans	$2,148	2416%

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 $295.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Stoughton Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73502.
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.