X-ray, shoulder
Facility: Menorah Medical Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $699
- Cash Discount Price: $2,760
- vs. Medicare Baseline: 7.86x 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 786% of the Medicare baseline (a markup of 686%). 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 - $2,722 | 29% |
| Corvel Corporation | $31 - $2,391 | 35% |
| Oha Network | $32 - $1,840 | 36% |
| Aetna | $37 - $1,876 | 42% |
| Blue Cross Blue Shield | $38 - $1,656 | 43% |
| Humana | $38 - $49 | 43% |
| United | $49 - $1,656 | 55% |
| Amerigroup | $49 | 55% |
| Healthyblue | $50 | 56% |
| Medicaid / KanCare | $50 | 56% |
| Unicare | $51 | 57% |
| Home State Health Plan | $79 | 89% |
| Cigna | $101 - $2,943 | 114% |
| Ambetter / Centene | $342 - $684 | 385% |
| Nhc Advantage | $350 - $699 | 394% |
| Wppa Providrs Care Network | $368 - $736 | 414% |
| Universal Healthcare | $644 - $1,288 | 724% |
| Coventry | $740 - $1,479 | 832% |
| Coventry Kc Mo | $754 - $1,508 | 848% |
| College Park Family Care Center | $791 - $1,582 | 890% |
| Cco, Inc. | $1,380 - $2,759 | 1552% |
| Focus Healthcare Mgmt, Inc | $1,380 - $2,759 | 1552% |
| Triwest Health Alliance | $1,380 - $2,759 | 1552% |
Consumer Guidance & Cost Commentary
For this X-ray of the shoulder at Menorah Medical Center in Overland Park, KS, the cash price is $2,760, which matches the facility's listed cash median. While the facility's negotiated rates for various payers range from $31 to $2,943, the cash price remains the highest figure in this dataset. It is important to note that for patients with high-deductible plans, paying the cash price of $2,760 upfront can sometimes be more cost-effective than relying on insurance, as many commercial negotiated rates exceed this amount. Additionally, patients should explicitly ask the hospital about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the facility's gross chargemaster. The Medicare amount for this procedure is $88.91, and the facility's cash price represents a markup of 7.9 times the Medicare rate. While commercial negotiated rates often average 200% to 300% of Medicare, fair pricing is typically defined as 120% to 150% of the Medicare amount. Patients should be aware that hospitals may issue summary bills that obscure individual charges; requesting a full itemized CPT-coded bill is the most effective way to identify errors, unbundled codes, or services not rendered before finalizing payment.