X-ray, shoulder
Facility: Pratt Regional Medical Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $75
- Cash Discount Price: $57
- vs. Medicare Baseline: 0.84x 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 |
|---|---|---|
| Christian Health Aid | $21 - $344 | 24% |
| UnitedHealthcare | $23 - $467 | 26% |
| Health Partners Of Kansas | $24 - $389 | 27% |
| Aetna | $25 - $412 | 28% |
| Choicecare | $28 - $458 | 31% |
| Celtic Insurance Company | $84 | 94% |
| Healthy Blue | $87 | 98% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Pratt Regional Medical Center in Pratt, KS, the cash median price is $57.00, which is lower than the facility's gross charge of $81.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $23 to $467, the cash price may be more cost-effective for patients with high-deductible plans or those without insurance, as the cash rate is significantly below the negotiated amounts. It is important to note that commercial rates often include administrative overhead and contract markups that exceed the true cost of care, making the cash option a potential way to avoid balance billing if you are out-of-network or if your insurer pays less than the cash price.
To ensure you are receiving the best possible rate, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill. Additionally, since over 80% of hospital bills contain errors, we strongly advise requesting a full itemized billing audit rather than accepting a summary invoice; this allows you to identify unbundled codes or services not rendered before payment. While this specific data point does not include a direct comparison to state or county averages, understanding that Medicare rates ($88.91) serve as a reliable benchmark for fair pricing can help you evaluate whether the facility's commercial rates are reasonable, as fair pricing is typically defined as 120% to 150% of the Medicare amount.