CMS Price Transparency Data

X-ray, shoulder

Facility: Childrens Hospital of Wisconsin

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $362
Cash Discount Price: $235
vs. Medicare Baseline: 4.07x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Childrens Hospital of Wisconsin is $362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $235. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.07x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.

Cash / Self-Pay

$235

Average discount available for prompt cash payment at this facility.

Insurance Median

$362

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: $235 (264%)

Insurance Median: $362 (407%)

Cash: $235 (264% of Medicare)

Ins. Median: $362 (407% 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 407% of the Medicare baseline (a markup of 307%). 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
Froedtert Health	$300 - $364	337%
Medical College Of Wisconsin	$300	337%
Network Health Plan	$305	343%
UnitedHealthcare	$315 - $326	354%
Aspirus Health Plan	$321	361%
Common Ground Healthcare Cooperative	$321 - $364	361%
Trilogy Health Solutions	$321 - $364	361%
Wps Health Plan	$325 - $385	366%
Advocate Aurora Healthcare	$330	371%
Blue Cross Blue Shield	$334 - $407	376%
Centivo	$334	376%
Health Partners	$334 - $377	376%
Employer Health Care Alliance Cooperative	$336	378%
Dean Health Plan	$342	385%
Group Health Cooperative Of Eau Claire	$342	385%
Oan Llc	$342	385%
Security Health Plan	$355	399%
Health Payment Systems	$362	407%
Praire States	$364	409%
Quartz Health Insurance	$364	409%
Sheboygan Employer'S Health Network	$364	409%
Mayo Clinic Health Solutions	$372	418%
Aetna	$377 - $381	424%
Bellin Thedacare	$385	433%
Cigna	$385	433%
Group Health Cooperative Of South Central Wisconsin	$385	433%
Prevea Health Network	$385	433%
Multiplan	$389 - $407	438%
Coventry Health Care	$407	458%

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 $235.
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 Childrens Hospital of Wisconsin 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.