X-ray, shoulder
Facility: Lmh
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $197
- Cash Discount Price: $207
- vs. Medicare Baseline: 2.22x 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 222% of the Medicare baseline (a markup of 122%). 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 - $733 | 55% |
| Blue Cross Blue Shield | $49 - $714 | 55% |
| Haskell Indian Health Services | $88 | 99% |
| Cigna | $88 - $738 | 99% |
| Humana | $88 | 99% |
| Medicare (plans) | $88 | 99% |
| Allwell | $89 | 100% |
| Ambetter / Centene | $136 | 153% |
| Aetna | $352 - $917 | 396% |
| Non Contracted | $442 - $883 | 497% |
| First Health | $513 - $1,027 | 577% |
Consumer Guidance & Cost Commentary
For this shoulder X-ray service at Lmh in Lawrence, KS, the facility's cash price of $207.00 is significantly lower than the negotiated rates charged by most insurance plans, which range from $49 to over $1,000 depending on the carrier. While Medicare sets a baseline payment of $88.91 for this procedure, the facility's cash rate is more than double the Medicare amount, yet it remains the most affordable option for patients without insurance or those with high-deductible plans. It is important to note that while commercial insurance contracts often cap charges at negotiated rates, these rates frequently include administrative overhead and can exceed the cash price; therefore, patients with high deductibles may save money by paying the cash rate directly rather than relying on insurance coverage that could result in higher out-of-pocket costs if the deductible is not yet met.
To ensure you receive the best possible rate, we recommend contacting the hospital directly to confirm if they offer "self-pay" or "prompt-pay" discounts, which can further reduce the bill by 20% to 50% if paid in full upfront. Since this facility is a government-owned acute care hospital, their pricing structure may differ from private operators, but verifying the specific discount terms before scheduling is essential to avoid unexpected balances. Additionally, if you have insurance, always request an itemized bill after services are rendered to review every code and ensure no errors or unbundled charges exist, as over 80% of hospital bills contain discrepancies that can be corrected through a formal audit.