X-ray, shoulder
Facility: Overland Park Reg Med Ctr
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $671
- Cash Discount Price: $2,366
- vs. Medicare Baseline: 7.55x 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 755% of the Medicare baseline (a markup of 655%). 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 |
|---|---|---|
| Multiplan | $26 - $2,484 | 29% |
| Corvel Corporation | $31 - $2,182 | 35% |
| Oha Network | $32 - $1,678 | 36% |
| Aetna | $37 - $1,712 | 42% |
| Blue Cross Blue Shield | $38 - $1,443 | 43% |
| Humana | $38 - $49 | 43% |
| United | $49 - $1,510 | 55% |
| Amerigroup | $49 | 55% |
| Medicaid / KanCare | $50 | 56% |
| Healthyblue | $50 | 56% |
| Unicare | $51 | 57% |
| Home State Health Plan | $79 | 89% |
| Cigna | $101 - $150 | 114% |
| Ambetter / Centene | $284 - $624 | 319% |
| Nhc Advantage | $290 - $638 | 326% |
| Wppa Providrs Care Network | $306 - $671 | 344% |
| Universal Healthcare | $535 - $1,175 | 602% |
| Coventry | $615 - $1,349 | 692% |
| Coventry Kc Mo | $627 - $1,376 | 705% |
| College Park Family Care Center | $657 - $1,443 | 739% |
| Triwest Health Alliance | $1,147 - $2,517 | 1290% |
| Cco, Inc. | $1,147 - $2,517 | 1290% |
| Focus Healthcare Mgmt, Inc | $1,147 - $2,517 | 1290% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030), the Overland Park Reg Med Ctr lists a cash price of $2,366.00, which matches the facility's cash median. This cash rate is significantly higher than the state of Kansas average, which is $88.91, and also exceeds the national Medicare benchmark of $88.91. While commercial insurance contracts often cap costs, the negotiated rates for this service range widely across payers, with the lowest allowed amount being $26.00 (Multiplan) and the highest reaching $2,517.00 (Triwest Health Alliance and Cco, Inc.). Because insurance negotiated rates can sometimes exceed the cash price due to administrative overhead and contract structures, patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, provided they verify the specific allowed amount with their insurer first.
To minimize potential costs, patients should proactively ask the facility about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront. It is also important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services like emergency physicians or labs are billed separately. Before scheduling, consumers should request a full, itemized bill to review specific CPT codes and avoid paying for services not rendered or unbundled charges, ensuring they are not signing away rights to dispute errors. Given the wide variance in payer rates, comparing the facility's specific negotiated amounts against the state average and Medicare benchmark provides a clearer