X-ray, shoulder
Facility: Ellinwood District Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $68
- Cash Discount Price: $82
- vs. Medicare Baseline: 0.76x 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 |
|---|---|---|
| Cigna | $68 | 76% |
| UnitedHealthcare | $68 | 76% |
| Humana | $68 | 76% |
| Aetna | $68 | 76% |
| Blue Cross Blue Shield | $68 | 76% |
Consumer Guidance & Cost Commentary
For this X-ray, shoulder procedure at Ellinwood District Hospital in Ellinwood, KS, the negotiated rate for all five major payers is $68.00, which matches the facility's cash median price of $82.00. This suggests that for patients with high-deductible plans, paying cash directly might not offer savings compared to using insurance, as the negotiated amount is already lower than the cash price. However, patients should still verify if the hospital offers a "prompt-pay" discount for upfront payment, as these incentives can reduce the final cost by 20% to 50% by bypassing administrative processing fees.
The facility's negotiated rate of $68.00 is significantly lower than the Medicare benchmark of $88.91, indicating a markup of only 0.8 times the Medicare rate, which aligns with fair pricing standards rather than the typical 200% to 300% markups seen in commercial billing. While the data does not provide specific state or county average comparisons, the facility's pricing structure demonstrates a transparent approach where the commercial rate is well below the government-set baseline. Consumers are advised to request an itemized bill to ensure no unbundled charges or services not rendered are included, and to dispute any balance billing immediately if it occurs, as federal protections under the No Surprises Act may apply depending on the specific services rendered.