X-ray, shoulder
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $459
- Cash Discount Price: $280
- vs. Medicare Baseline: 5.16x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 516% of the Medicare baseline (a markup of 416%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Healthcare Highways [2210] | $306 - $459 | 344% |
| Oncology Patient Assistance Programs [2295] | $306 - $459 | 344% |
| Black Lung [6055] | $306 - $459 | 344% |
| Lucent Health [6000] | $306 - $459 | 344% |
| Aetna | $306 - $459 | 344% |
| Web Tpa [2115] | $306 - $459 | 344% |
| Blue Cross Blue Shield | $306 - $459 | 344% |
| Hooray Health [8000] | $306 - $459 | 344% |
| Department Of Corrections [1340] | $374 - $560 | 421% |
| National Association Of Letter Carriers [1695] | $432 - $648 | 486% |
| Healthpartners [1500] | $432 - $648 | 486% |
| American Postal Workers Union [1070] | $432 - $648 | 486% |
| Cigna | $432 - $648 | 486% |
| Humana | $441 - $661 | 496% |
| American Healthcare [1055] | $580 - $871 | 652% |
| Administrative Concepts [1005] | $580 - $871 | 652% |
| First Health [1375] | $580 - $871 | 652% |
| Multiplan [1680] | $580 - $871 | 652% |
| UnitedHealthcare | $610 - $914 | 686% |
| Healthscope Benefits [2290] | $610 - $914 | 686% |
| Geha [1415] | $610 - $914 | 686% |
| Coventry Healthcare [1320] | $613 - $919 | 689% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at the University Of Kansas Health System - St Francis Campus in Topeka, KS, the facility's cash median rate is $280.00, which is significantly lower than the negotiated rates paid by insurance plans ranging from $306 to $919. While the facility's negotiated rate of $459.00 is lower than its gross charge of $934.00, it remains higher than the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate of $280.00 upfront, as this avoids the administrative overhead and potential balance billing associated with insurance claims. It is important to note that the facility is a voluntary non-profit church-owned acute care hospital located in zip code 66606, and patients should explicitly request a self-pay or prompt-pay discount before scheduling to ensure the lowest possible out-of-pocket cost.
The facility's pricing structure is evaluated against federal benchmarks, with the Medicare amount for this service set at $88.91. The cash rate of $280.00 represents a markup of 5.2 times the Medicare amount, which is consistent with the typical range of 200% to 300% of Medicare for commercial rates, though the specific ratio here reflects the facility's unique pricing model. Commercial negotiated rates for this code vary widely across payers, with some plans like UnitedHealthcare and Coventry Healthcare paying up to $919, while others such as Healthcare Highways and Aetna pay as low as $459. To avoid unexpected