X-ray, shoulder
Facility: Mcpherson Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $77
- Cash Discount Price: $60
- vs. Medicare Baseline: 0.87x 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 |
|---|---|---|
| UnitedHealthcare | $7 - $425 | 8% |
| Tricare | $8 - $70 | 9% |
| Humana | $9 - $80 | 10% |
| Wellcare Mcr Adv - All Plans | $9 - $80 | 10% |
| Ambetter / Centene | $9 - $92 | 10% |
| Va Ccn - All Plans | $9 - $80 | 10% |
| Healthy Blue Mcr Adv | $9 - $80 | 10% |
| Blue Cross Blue Shield | $9 - $80 | 10% |
| Aetna | $9 - $425 | 10% |
| Multiplan - All Plans | $11 - $382 | 12% |
| Medicaid / KanCare | $27 - $425 | 30% |
| Health Blue Mcaid - All Other Plans | $28 - $434 | 31% |
| Central Plains - All Plans | $46 - $319 | 52% |
| Medical Associates - All Plans | $46 - $319 | 52% |
| Wppa - All Plans | $57 - $298 | 64% |
| Health Partners - All Plans | $58 - $404 | 65% |
| Cigna | $58 - $404 | 65% |
| Christian Health Aid - All Plans | $65 - $340 | 73% |
| First Health - All Plans | $77 - $404 | 87% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder) at McPherson Hospital in Mcpherson, KS, the cash median price is $60.00, which is lower than the facility's gross charge of $81.00. While the facility offers a negotiated rate of $77.00 to in-network payers, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $60.00. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the actual cost of care; for context, fair pricing is typically defined as 120% to 150% of the Medicare benchmark of $88.91 for this procedure. Patients should verify their specific plan's allowed amount before scheduling, as assuming that in-network status guarantees the lowest possible price can lead to higher out-of-pocket costs if the deductible has not yet been met.
To minimize potential surprise costs, consumers should proactively request a "self-pay" or "prompt-pay" discount from the hospital before check-in, which can reduce the bill by 20% to 50% for upfront payment. If a balance bill arises from an out-of-network service, patients should not pay immediately out of fear of credit damage; instead, they should dispute the bill with their insurer and request a No Surprises Act audit, as federal protections ban balance billing for emergency and non-emergency services at in-network facilities. Additionally, if a summary bill is received, patients should demand a full itemized CPT-coded statement to identify errors, unbundled codes, or services not rendered, as