X-ray, shoulder
Facility: Saint Luke'S South Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $567
- Cash Discount Price: $946
- vs. Medicare Baseline: 6.38x 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 638% of the Medicare baseline (a markup of 538%). 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 |
|---|---|---|
| Aetna | $26 - $1,797 | 29% |
| Humana | $27 - $44 | 30% |
| Blue Cross Blue Shield | $28 - $1,421 | 31% |
| Transplants-Case Rates [5750] | $37 - $1,892 | 42% |
| UnitedHealthcare | $42 - $296 | 47% |
| Medicaid / KanCare | $49 - $113 | 55% |
| Cigna | $78 - $1,436 | 88% |
| Commercial-Contracted [8000] | $251 - $1,531 | 282% |
| First Health [5512] | $748 - $1,122 | 841% |
Consumer Guidance & Cost Commentary
For the CPT code 73030, representing an X-ray of the shoulder, Saint Luke's South Hospital in Overland Park, KS, has a cash median price of $946.00. This cash rate is notably higher than the facility's negotiated rates, which range from $26 to $1,892 depending on the payer. While commercial insurance plans like Aetna and Humana have negotiated ceilings as low as $26 and $27 respectively, these rates often include administrative overhead and do not reflect the lowest possible cost for patients. For individuals with high-deductible plans, paying the cash price of $946.00 upfront may be more economical than relying on insurance, especially if the negotiated rate exceeds the cash amount or if the patient's deductible has not yet been met.
The facility's pricing is also evaluated against federal benchmarks, showing a markup of 6.4 times the Medicare amount of $88.91 for this service. Although the facility holds a 4-star rating and is a voluntary non-profit, patients should be aware that the gross charge of $1,577.00 represents the full list price before any discounts are applied. To secure the best possible payment, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full prior to discharge. Additionally, patients should request an itemized bill to verify that all charges are accurate and that no unnecessary services were billed, as over 80% of hospital invoices contain errors that can be corrected through a formal audit.