X-ray, hand
Facility: Lane County Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $201
- Cash Discount Price: $201
- vs. Medicare Baseline: 2.26x 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 226% of the Medicare baseline (a markup of 126%). 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 |
|---|---|---|
| UnitedHealthcare | $181 - $201 | 204% |
| Aetna | $181 - $191 | 204% |
| Healthy Blue Mcr Adv - All Other Plans | $201 | 226% |
| Medicaid / KanCare | $201 - $221 | 226% |
| Healthy Blue Mcaid | $201 | 226% |
| Wppa Providers-All Plans | $302 | 340% |
Consumer Guidance & Cost Commentary
For the CPT code 73130 (X-ray, hand) at Lane County Hospital in Dighton, KS, the cash price is $201.00, which matches the facility's negotiated rate and the median amount paid by insurers. This rate is significantly higher than the Medicare benchmark of $88.91, reflecting a markup typical of commercial pricing structures. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rate, which can sometimes exceed the cash amount due to administrative costs and contract dynamics. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can reduce the final bill by 20% to 50%.
The data indicates that commercial payers such as UnitedHealthcare and Aetna negotiate rates ranging from $181 to $201, while Medicaid plans pay between $201 and $221. Although specific county or state average data was not provided in the source material, the facility's rates are anchored firmly at the Medicare benchmark of $88.91, serving as the objective baseline for evaluating pricing fairness. Consumers should be aware that balance billing is generally prohibited for emergency services at in-network facilities under the No Surprises Act, but it is crucial to request an itemized bill to ensure no unbundled charges or services not rendered are included. If a large bill arrives, patients should dispute any discrepancies in writing rather than accepting summary invoices, as over 80% of hospital bills contain errors that can be corrected through a formal audit