X-ray, shoulder
Facility: Saint John Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $82
- Cash Discount Price: $81
- vs. Medicare Baseline: 0.92x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Comp Alliance Workers Comp | $29 | 33% |
| Oha Networks | $31 | 35% |
| Worker Compensation | $32 | 36% |
| Aetna | $48 - $82 | 54% |
| Medicaid / KanCare | $49 | 55% |
| Blue Cross Blue Shield | $67 - $140 | 75% |
| UnitedHealthcare | $74 - $115 | 83% |
| Healthy Blue | $75 - $86 | 84% |
| Celtic | $75 - $131 | 84% |
| Midland Care Connection | $82 | 92% |
| Tricare | $82 | 92% |
| Medicare (plans) | $82 | 92% |
| Cigna | $82 | 92% |
| Kansas Superior Select | $84 | 94% |
| Corizon | $115 | 129% |
| Well Path | $115 | 129% |
| Employer Direct Healthcare | $115 | 129% |
| Centurion | $123 | 138% |
| Naphcare | $127 | 143% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder) at Saint John Hospital in Leavenworth, KS, the cash price is $81.00, which is significantly lower than the facility's negotiated rates. While the facility's median negotiated rate is $82.00, commercial payers like Aetna and Blue Cross Blue Shield have negotiated rates ranging from $48 to $140, and Medicaid/KanCare has a rate of $49.00. It is important to note that cash-pay can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. Patients should verify their specific plan's allowed amount and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront.
This service is benchmarked against Medicare, which sets a fixed reimbursement rate of $88.91 for this procedure. The facility's cash price of $81.00 is slightly below the Medicare amount (0.9x), while the median negotiated rate of $82.00 is also below the Medicare benchmark. Commercial rates vary widely across payers, with some plans paying as high as $140.00, which is substantially higher than the Medicare baseline. Since Medicare rates represent a scientifically validated cost baseline, patients should compare their specific insurance allowed amounts to this figure rather than the hospital's gross charges to understand the true cost of care.