X-ray, hand
Facility: Ellinwood District Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $126
- Cash Discount Price: $153
- vs. Medicare Baseline: 1.42x 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 |
|---|---|---|
| Blue Cross Blue Shield | $126 | 142% |
| Humana | $126 | 142% |
| UnitedHealthcare | $126 | 142% |
| Cigna | $126 | 142% |
| Aetna | $126 | 142% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Ellinwood District Hospital, the negotiated rate of $126.00 aligns perfectly with the lowest and highest amounts paid by all five major payers, including Blue Cross Blue Shield, Humana, UnitedHealthcare, Cigna, and Aetna. While the facility's cash price of $153.00 is higher than the negotiated amount, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rate exceeds the cash price, though in this specific case, the insurance rate is lower. It is important to note that this facility is a Critical Access Hospital in Ellinwood, KS, and while no state or county average data was provided to compare against, the consistency across all payer plans suggests a stable, non-negotiated pricing structure for this service.
The Medicare benchmark for this procedure is $88.91, which serves as the objective baseline for evaluating pricing markups. The facility's negotiated rate of $126.00 represents a 1.4x multiplier compared to the Medicare amount, indicating a markup that exceeds the typical fair pricing range of 120% to 150% of Medicare. To ensure you are receiving the best possible rate, we recommend requesting a full itemized bill before payment to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Additionally, since this is a government-owned facility, you should inquire directly about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled upfront, bypassing