X-ray, hand
Facility: Nmc Health
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $136
- Cash Discount Price: $213
- vs. Medicare Baseline: 1.53x 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 |
|---|---|---|
| Bluestem Pace | $8 - $84 | 9% |
| Medicaid / KanCare | $13 - $134 | 15% |
| Leading Age | $13 - $134 | 15% |
| Wppa | $15 - $327 | 17% |
| Occunet | $16 - $357 | 18% |
| Samaritan Ministries International | $18 - $387 | 20% |
| Medincrease Health Plan | $18 - $387 | 20% |
| Prime Health Services | $20 - $446 | 22% |
| Aetna | $22 - $45 | 25% |
| UnitedHealthcare | $24 - $536 | 27% |
| Cigna | $26 - $565 | 29% |
| Blue Cross Blue Shield | $137 | 154% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Nmc Health in Newton, KS, the cash price is $213.00, which is lower than the facility's gross charge of $331.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Cigna range from $24 to $565, these amounts often exceed the cash price. For patients with high-deductible plans, paying the cash rate of $213.00 upfront can be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the negotiated rate exceeds the cash price. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final bill.
The facility's pricing is evaluated against the Medicare benchmark of $88.91, which serves as the objective baseline for healthcare costs. The cash rate of $213.00 represents a markup of 1.5 times the Medicare amount, while the median negotiated rate across payers is $136.00. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price compared to the true cost of care. If you receive a bill, always request a full itemized CPT-coded statement to verify that charges are accurate and that no services were unbundled or double-billed, as over 80% of hospital bills contain errors that can be corrected through a formal audit dispute.