X-ray, shoulder
Facility: Stormont Vail Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $79
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.89x 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 |
|---|---|---|
| Blue Cross Blue Shield | $50 - $383 | 56% |
| UnitedHealthcare | $50 - $75 | 56% |
| Ambetter / Centene | $50 - $75 | 56% |
| Aetna | $79 - $81 | 89% |
| Humana | $79 - $81 | 89% |
Consumer Guidance & Cost Commentary
For this X-ray, shoulder procedure at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates range from $50 to $81 across five major payers, with a median paid amount of $81.00. This negotiated rate is 90% of the Medicare benchmark of $88.91, indicating the facility is pricing at a level consistent with fair market value rather than inflating charges above the federal baseline. While the facility is a voluntary non-profit acute care hospital, patients should note that cash-pay options are not listed in this report; however, it is always advisable to inquire directly with the hospital about self-pay or prompt-pay discounts before scheduling, as these upfront incentives can significantly reduce out-of-pocket costs compared to the standard insurance negotiated rates.
It is important to understand that commercial insurance rates often exceed cash prices due to the administrative costs and risk premiums built into insurance contracts. If you have a high-deductible plan, paying the cash price directly might be cheaper than your insurance allowing a higher negotiated rate, provided you can afford the upfront cost. Furthermore, if you receive care from an out-of-network provider at this in-network facility, you are protected by the No Surprises Act, which prevents balance billing for emergency and non-emergency services. If you do receive a surprise bill, you should dispute it in writing with the insurer rather than paying immediately, and you should request a full itemized audit to ensure no unbundled codes or services not rendered are included in your final charge.