X-ray, shoulder
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $80
- Cash Discount Price: $239
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Humana | $78 | 88% |
| United Mine Workers Of America | $80 | 90% |
| Blue Cross Blue Shield | $80 | 90% |
| Aetna | $80 - $100 | 90% |
| UnitedHealthcare | $80 - $97 | 90% |
| Providrs Care Network | $80 | 90% |
| Lantern Specialty Care | $128 | 144% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the facility's negotiated rates range from $78 to $128 depending on the insurance carrier, with a median negotiated rate of $80. This facility is classified as an Acute Care Hospital with Physician ownership. While the facility's cash price of $239 is higher than the median paid amount of $110, patients with high-deductible plans may find that paying cash upfront is more cost-effective than relying on insurance, as the insurance negotiated rate often exceeds the cash price. It is important to note that while the facility is located in Wichita (ZIP 67226), the provided data does not include specific county or state average comparisons for this procedure, so direct regional benchmarking is not available in this report.
Patients should be aware that commercial insurance rates can sometimes be inflated due to administrative costs and contract dynamics, which is why comparing rates to the Medicare benchmark is a critical step in understanding true value. For this service, the Medicare amount is $88.91, and the facility's vs. Medicare ratio is 0.9, indicating the facility's rates are generally aligned with or below the federal baseline for this specific code. To minimize costs, consumers 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. Additionally, if a patient receives an unexpected balance bill after insurance payment, they should verify if the provider is truly out-of-network or if the service was bundled, as federal protections like the No Surprises Act may prevent