X-ray, shoulder
Facility: Providence Medical Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $82
- Cash Discount Price: $81
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| Comp Alliance - Fka Compresults Worker Compensation | $29 | 33% |
| Oha Networks | $31 | 35% |
| Worker Compensation | $32 | 36% |
| Aetna | $36 - $82 | 40% |
| Medicaid / KanCare | $49 | 55% |
| UnitedHealthcare | $74 - $115 | 83% |
| Celtic | $75 - $131 | 84% |
| Healthy Blue | $75 - $86 | 84% |
| Medicare (plans) | $82 | 92% |
| Tricare | $82 | 92% |
| Midland Care Connection | $82 | 92% |
| Cigna | $82 | 92% |
| Kansas Superior Select | $86 | 97% |
| Corizon | $107 | 120% |
| Well Path Prison | $115 | 129% |
| Employer Direct Healthcare | $115 | 129% |
| Centurion | $123 | 138% |
| Naphcare | $127 | 143% |
| Blue Cross Blue Shield | $131 - $212 | 147% |
| First Health | $750 | 844% |
Consumer Guidance & Cost Commentary
For this X-ray, shoulder procedure at Providence Medical Center in Kansas City, KS, the cash price is $81.00, which is significantly lower than the facility's negotiated rates. While the median negotiated amount across payers is $129.00, the cash rate offers a substantial discount for patients who do not have insurance or have high deductibles. It is important to note that commercial insurance rates can sometimes exceed the cash price due to administrative overhead and contract dynamics; therefore, self-pay patients should explicitly ask the hospital about "prompt-pay" discounts or self-pay rates before scheduling to ensure they are not paying more than necessary.
The facility's pricing is evaluated against federal benchmarks to ensure transparency. The Medicare benchmark for this service is $88.91, and the facility's negotiated rates generally align closely with this baseline, with the lowest negotiated rate being $29.00 and the highest reaching $750.00 across different payers. Because commercial rates vary widely depending on the specific insurance plan, patients should verify their individual allowed amounts rather than assuming the facility's general rates apply. If you receive a bill that appears to include balance billing for out-of-network services, you have the right to dispute it under the No Surprises Act, and you should always request a detailed, itemized bill to identify any errors or unbundled charges before making a payment.