CMS Price Transparency Data

X-ray, hand

Facility: Elkhart General Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $225
Cash Discount Price: $305
vs. Medicare Baseline: 2.53x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Elkhart General Hospital is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.53x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$305

Average discount available for prompt cash payment at this facility.

Insurance Median

$225

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: $305 (343%)

Insurance Median: $225 (253%)

Cash: $305 (343% of Medicare)

Ins. Median: $225 (253% 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 253% of the Medicare baseline (a markup of 153%). 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
Mclaren (Mi	$49	55%
UnitedHealthcare	$49 - $421	55%
Devoted Healthcare	$63 - $125	71%
Blue Cross Blue Shield	$66 - $275	74%
Caresource	$66 - $814	74%
Humana	$66 - $438	74%
Mdwise	$66 - $814	74%
Mhs	$66 - $814	74%
Aetna	$92 - $424	103%
Pace	$92	103%
Plain Church	$138 - $501	155%
Cha	$188 - $488	211%
Immergrun	$188 - $501	211%
Php	$203 - $438	228%
Cigna	$225 - $476	253%
Multiplan	$225 - $451	253%
Signature	$228 - $457	256%
Encore	$232 - $463	261%
Heartland	$313 - $626	352%

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 $305.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Elkhart General Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
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.