X-ray, hand
Facility: Lmh
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $191
- Cash Discount Price: $168
- vs. Medicare Baseline: 2.15x 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 215% of the Medicare baseline (a markup of 115%). 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 |
|---|---|---|
| UnitedHealthcare | $49 - $596 | 55% |
| Blue Cross Blue Shield | $49 - $581 | 55% |
| Haskell Indian Health Services | $88 | 99% |
| Medicare (plans) | $88 | 99% |
| Humana | $88 | 99% |
| Cigna | $88 - $600 | 99% |
| Allwell | $89 | 100% |
| Ambetter / Centene | $136 | 153% |
| Aetna | $286 - $745 | 322% |
| Non Contracted | $359 - $718 | 404% |
| First Health | $418 - $835 | 470% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Lmh in Lawrence, KS, the facility's cash price of $168.00 is significantly lower than the gross charge of $674.00, offering a substantial discount for self-pay patients. While the facility is government-owned and located in Lawrence (ZIP 66044), the data does not provide specific county or state average figures for comparison. However, the cash rate is notably lower than the Medicare benchmark of $88.91 when adjusted for the facility's 2.1x markup relative to Medicare, suggesting that for patients without insurance or with high-deductible plans, paying cash upfront may be the most cost-effective option. Patients should verify if their specific insurance plan has a negotiated rate that exceeds this cash price, as commercial contracts often include administrative overhead that inflates the allowed amount above the direct cash cost.
Insurance coverage varies widely across the 11 payers represented, with negotiated rates ranging from $49 to $835 depending on the carrier and contract status. UnitedHealthcare and Blue Cross Blue Shield have the widest ranges ($49–$596 and $49–$581, respectively), while non-contracted payers can charge up to $745. It is important to note that even though many payers are in-network, the negotiated rates are not uniform; for instance, First Health's range ($418–$835) is higher than the cash price, meaning a patient might save money by paying out-of-pocket. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often offer