X-ray, shoulder
Facility: Grisell Memorial Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $209
- Cash Discount Price: $228
- vs. Medicare Baseline: 2.35x 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 235% of the Medicare baseline (a markup of 135%). 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 | $132 | 148% |
| UnitedHealthcare | $179 - $240 | 201% |
| Medicaid / KanCare | $240 | 270% |
| Humana | $240 | 270% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Grisell Memorial Hospital in Ransom, KS, the facility's cash median price of $228.00 is notably lower than the negotiated rates charged by major payers. While UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $179 to $240, the cash price offers a potential savings of up to $12 for patients who qualify. It is important to note that for individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash rate directly can sometimes be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the negotiated rate exceeds the cash price. Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
The facility's pricing structure is significantly higher than the federal baseline, with the cash median of $228.00 representing a markup of 2.4 times the Medicare amount of $88.91 for this specific service. Although the facility is a Critical Access Hospital owned by a Government Hospital District, the negotiated rates for Medicaid/KanCare and Humana remain at the full gross charge of $240.00, indicating no contractual discount for these specific plans. To ensure you are receiving the most accurate pricing, always request an itemized bill that breaks down every CPT code and charge, as summary bills often obscure individual line items. If you receive a balance bill for services rendered at this in-network facility, you may be entitled