Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PR SINGLE ENERGY X-RAY STUDY (TC)
Cedar Rapids, IA
See all hospitals reporting HCPCS G0130 →Price type
St Luke's Methodist Hospital’s median price of $36 is 68% below the median hospital's median price ($111), higher than 12% of the 1,147 hospitals reporting HCPCS G0130. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 22 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna medicare advantage fee schedule · both | $24 | $23 | $10 | 43% | — | $10 – $34 |
| 2 | Molina medicare advantage fee schedule · both | $24 | $23 | $10 | 43% | — | $10 – $35 |
| 3 | Wellmark medicare advantage fee schedule · both | $24 | $23 | $10 | 43% | — | $10 – $35 |
| 4 | Humana medicare advantage fee schedule · both | $25 | $24 | $10 | 43% | — | $11 – $36 |
| 5 | UnitedHealthcare medicare advantage fee schedule · both | $25 | $24 | $10 | 43% | — | $11 – $36 |
| 6 | UnitedHealthcare hmo fee schedule · both | $28 | $28 | $12 | 41% | — | $14 – $43 |
| 7 | UnitedHealthcare ppo fee schedule · both | $28 | $28 | $12 | 41% | — | $14 – $43 |
| 8 | Wellmark commercial fee schedule · both | $38 | $36 | $16 | 44% | — | $16 – $53 |
| 9 | Wellmark hmo fee schedule · both | $38 | $36 | $16 | 44% | — | $16 – $53 |
| 10 | Wellmark ppo fee schedule · both | $45 | $42 | $18 | 44% | — | $18 – $63 |
| 11 | Aetna hmo fee schedule · both | $52 | $51 | $21 | 42% | — | $24 – $76 |
| 12 | Cigna commercial fee schedule · both | $60 | $58 | $25 | 43% | — | $26 – $86 |
| 13 | Aetna ppo fee schedule · both | $62 | $60 | $25 | 42% | — | $28 – $90 |
| 14 | Aetna medicare advantage case rate · outpatient | $101 | $101 | — | — | — | $101 – $101 |
| 15 | Molina medicare advantage case rate · outpatient | $101 | $101 | — | — | — | $101 – $101 |
| 16 | Wellmark medicare advantage case rate · outpatient | $101 | $101 | — | — | — | $101 – $101 |
| 17 | Humana medicare advantage case rate · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 18 | UnitedHealthcare medicare advantage case rate · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 19 | Aetna hmo fee schedule · outpatient | $208 | $208 | — | — | — | $208 – $208 |
| 20 | Aetna ppo fee schedule · outpatient | $216 | $216 | — | — | — | $216 – $216 |
| 21 | UnitedHealthcare hmo fee schedule · outpatient | $265 | $265 | — | — | — | $265 – $265 |
| 22 | UnitedHealthcare ppo fee schedule · outpatient | $265 | $265 | — | — | — | $265 – $265 |
Last updated: Jan 28, 2026
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