X-ray, shoulder
Facility: University Of Kansas Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $538
- Cash Discount Price: $262
- vs. Medicare Baseline: 6.05x 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 605% of the Medicare baseline (a markup of 505%). 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 |
|---|---|---|
| Hchsync Centrus Health Direct [503999916] | $45 - $918 | 51% |
| Larned State Hospital [503200090] | $45 - $773 | 51% |
| Health Plan Inc [503999941] | $71 - $1,232 | 80% |
| Alt Carelon Behavioral Health [503200905] | $76 - $1,311 | 85% |
| Accarent Health [503999034] | $76 - $1,311 | 85% |
| Tricare | $81 | 91% |
| Triwest [503201703] | $81 | 91% |
| Medicare (plans) | $81 - $83 | 91% |
| Humana | $81 - $83 | 91% |
| Devoted [503200068] | $81 | 91% |
| Lasso Healthcare [503999926] | $81 | 91% |
| UnitedHealthcare | $81 - $130 | 91% |
| Aetna | $81 - $114 | 91% |
| Workers Comp [503999901] | $81 - $2,491 | 91% |
| Ku Athletics [503200094] | $81 | 91% |
| Allwell [503200078] | $84 | 94% |
| Blue Cross Blue Shield | $84 - $2,012 | 94% |
| American Health Plans [503200968] | $85 | 96% |
| Med-Pay [503200040] | $91 - $1,588 | 102% |
| Healthlink [503200007] | $91 - $1,938 | 102% |
| Cerner [503200038] | $91 - $1,588 | 102% |
| Php [503200005] | $91 - $1,938 | 102% |
| Geha [503200036] | $91 - $1,588 | 102% |
| Inter-Americas Insurance [503999032] | $91 - $1,588 | 102% |
| Allied National [503999937] | $91 - $1,573 | 102% |
| Alt Wppa [5032000964] | $91 - $1,588 | 102% |
| Oscar [503201609] | $98 | 110% |
| First Health [5032000110] | $100 - $1,728 | 112% |
| Aha-Healthcare Preferred [503200050] | $100 - $1,728 | 112% |
| Ascension Living Hope [503201517] | $106 - $1,835 | 119% |
| Centurion [5032000966] | $106 | 119% |
| Correct Care Solutions [50311253] | $106 - $1,835 | 119% |
| Coeur Plan Services [503301517] | $106 - $1,835 | 119% |
| Consolidated Billing [50311256] | $106 - $1,835 | 119% |
| Orscheln Industries [503201608] | $113 - $1,966 | 127% |
| Empire Plan/Nyship [503200705] | $116 - $2,012 | 130% |
| Alt Lineco [5032000976] | $116 - $2,012 | 130% |
| Alt Lucent Health Solutions [503202603] | $116 - $2,012 | 130% |
| Cigna | $121 - $2,098 | 136% |
| Quiktrip [5032000412] | $121 - $2,098 | 136% |
| Point Comfort Underwriters [503200018] | $121 - $2,098 | 136% |
| Century Health Solutions [503200054] | $121 - $2,098 | 136% |
| Meritain Health [503200039] | $127 - $2,202 | 143% |
| Wppa [503200056] | $127 - $2,202 | 143% |
| Centivo [5032000982] | $134 | 151% |
| Wellfit [503301514] | $134 | 151% |
| Plan Care America [503999026] | $136 - $2,360 | 153% |
| Usa Managed Care [503999030] | $136 - $2,360 | 153% |
| Employers Health Network [503999025] | $136 - $2,360 | 153% |
| Three Rivers Provider Network [503999029] | $136 - $2,360 | 153% |
| Sanford Health Plan [503999027] | $136 - $2,360 | 153% |
| Ambetter / Centene | $138 | 155% |
| 6 Degrees Health [503999050] | $142 - $203 | 160% |
| Occunet [503999930] | $171 | 192% |
| Fort Hays State Student Athletes [5032000960] | $171 | 192% |
| Claimdoc [503301509] | $219 | 246% |
| Multiplan [503200057] | $219 | 246% |
| Advanced Medical Pricing Solutions [503301513] | $244 | 274% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder), the University of Kansas Hospital in Kansas City, KS, lists a gross charge of $1,311.00, which is significantly higher than the facility's cash median of $262.00. While the hospital is a government-owned acute care facility with a 5-star rating, patients should be aware that commercial negotiated rates vary widely among payers, ranging from $45 to $2,360. For instance, plans like HCH Sync Centrus Health and Larned State Hospital have negotiated rates as low as $45, whereas others such as Workers Comp and Plan Care America can reach up to $2,491 and $2,360 respectively. It is important to note that cash-pay options can sometimes be more cost-effective than insurance claims, especially for patients with high deductibles, as the cash median of $262.00 is substantially lower than the median negotiated rate of $538.00.
To avoid unexpected costs, patients should verify their specific plan's allowed amount before scheduling, as in-network rates do not guarantee the lowest possible price. The No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, but it is crucial to request a self-pay or prompt-pay discount upfront to bypass administrative fees and potential claim denials. If a patient receives an itemized bill, they should request a full line-by-line audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Comparing the facility's rates to the Medicare benchmark of $8