X-ray, shoulder

For the X-ray, shoulder procedure (CPT 73030), Mercy Specialty Hospital Southeast Kansas in Galena, KS has a cash median price of $352.00, which is significantly higher than the state average of $80.00. While the facility's negotiated rates for commercial payers range from $20 to $537, with many plans settling at the Medicare benchmark of $84.91, patients should be aware that cash payments can sometimes be more cost-effective if their insurance negotiated rates exceed the cash price. Given that the facility is a voluntary non-profit acute care hospital, it is advisable to contact the billing department directly to inquire about self-pay or prompt-pay discounts, which can reduce the final amount owed by bypassing administrative claim processing fees.

The facility's pricing structure shows a wide variance depending on the payer, with some contracted plans paying as low as $20 while others reach up to $537, far exceeding the Medicare amount of $88.91. To ensure you are not overcharged, it is important to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Additionally, under the No Surprises Act, you are protected from balance billing for emergency services or non-emergency services provided by out-of-network professionals at this in-network facility, so you should not feel pressured to pay unexpected differences immediately without first disputing the bill with your insurer.