X-ray, shoulder
Facility: Kansas Heart Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $135
- Cash Discount Price: $94
- vs. Medicare Baseline: 1.52x 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 |
|---|---|---|
| Wppa - All Plans | $60 | 67% |
| Tricare | $72 | 81% |
| Celtic Mcr Adv | $80 | 90% |
| Medicaid / KanCare | $80 - $150 | 90% |
| Humana | $80 | 90% |
| UnitedHealthcare | $80 - $150 | 90% |
| Blue Cross Blue Shield | $105 - $150 | 118% |
| Multiplan - All Plans | $135 | 152% |
| Aetna | $146 - $150 | 164% |
| Celtic Mcaid - All Other Plans | $150 | 169% |
| Soonerselect Mcaid - All Plans | $150 | 169% |
Consumer Guidance & Cost Commentary
For this X-ray of the shoulder at Kansas Heart Hospital in Wichita, KS, the facility's cash price of $94.00 is lower than the state average of $97.00, making it a competitive option for self-pay patients. While the hospital's negotiated rates with insurance plans range from $60 to $150, these amounts often exceed the cash price, which can be beneficial for individuals with high-deductible plans who may not yet have met their out-of-pocket limits. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final cost.
The facility's pricing structure is anchored by a Medicare benchmark of $88.91, which serves as a scientifically validated baseline for the true cost of care, rather than the hospital's inflated gross charge of $150.00. Although the facility's negotiated rates average $135.00, which is higher than the Medicare rate, this markup reflects standard administrative costs and contract dynamics rather than arbitrary price gouging. To ensure accuracy and avoid unexpected charges, patients should request a full itemized billing audit that breaks down every CPT code and service rendered, as over 80% of hospital bills contain errors such as double-billing or unbundled charges that can be corrected through a formal written dispute.