X-ray, hand
Facility: Grisell Memorial Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $198
- Cash Discount Price: $215
- vs. Medicare Baseline: 2.23x 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 223% of the Medicare baseline (a markup of 123%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $128 | 144% |
| UnitedHealthcare | $169 - $227 | 190% |
| Medicaid / KanCare | $227 | 255% |
| Humana | $227 | 255% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Grisell Memorial Hospital in Ransom, KS, the facility's cash price of $215.00 is lower than the median amount paid by insurance ($227.00) and significantly higher than the Medicare benchmark of $88.91. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans might find paying the cash price directly more affordable than relying on insurance, as the negotiated rates for payers like UnitedHealthcare and Humana can exceed the cash amount. It is important to note that while the facility offers a cash rate, patients should always ask specifically about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost by bypassing administrative processing fees.
The data indicates that the facility's negotiated rates vary by payer, ranging from $128 for Blue Cross Blue Shield to the full $227 for Medicaid and Humana, reflecting the complex dynamics of commercial contracts versus cash pricing. Although the provided data does not include specific state or county average comparisons for this procedure, the presence of a Medicare benchmark allows for a clear view of the markup; commercial rates are often substantially higher than the federal baseline due to administrative overhead and contract structures. To avoid unexpected costs, consumers should request an itemized bill to verify that no services were double-billed or unbundled, and if a balance bill arises from an out-of-network ancillary service, they may have protections under the No Surprises Act that prevent them from paying the difference between the allowed amount and the full chargemaster rate.