X-ray, shoulder
Facility: Kansas Medical Center Llc
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $77
- Cash Discount Price: $111
- vs. Medicare Baseline: 0.87x 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 |
|---|---|---|
| Aetna | $40 | 45% |
| Medicaid / KanCare | $49 | 55% |
| Indian Health | $72 | 81% |
| Tricare | $72 | 81% |
| Wppa | $74 | 83% |
| Ambetter / Centene | $80 | 90% |
| Medadv_Wellcare | $80 | 90% |
| Humana | $80 | 90% |
| Blue Cross Blue Shield | $80 - $134 | 90% |
| United | $84 | 94% |
| Three_Rivers | $160 | 180% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder) at Kansas Medical Center Llc in Andover, KS, the facility's cash median price is $111.00, which is higher than the state average of $80.00. While commercial insurance plans like Aetna and Medicaid/KanCare negotiate rates as low as $40, many other payers, including Blue Cross Blue Shield and United, have negotiated ranges starting at $80. For patients with high-deductible plans, paying the cash price of $111.00 upfront might be more cost-effective than relying on insurance, as the negotiated rates for some carriers exceed the cash amount. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the total cost significantly.
It is important to understand that commercial negotiated rates often include administrative overhead and do not represent the true cost of care; the Medicare benchmark for this service is $88.91, which serves as a scientifically validated baseline for fair pricing. Although the facility's cash rate is above the state average, the negotiated rates for many insurers are closer to the Medicare amount, suggesting that the administrative load of insurance billing inflates the final price paid by members. If you receive a bill that appears to include balance billing for out-of-network services at this in-network facility, you may be entitled to protections under the No Surprises Act, which bans balance billing for emergency and non-emergency services. Always request a full itemized CPT-coded bill before paying, as summary bills can obscure errors or unbundled charges that should be reviewed with the billing supervisor.