X-ray, shoulder
Facility: Lane County Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $263
- Cash Discount Price: $263
- vs. Medicare Baseline: 2.96x 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 296% of the Medicare baseline (a markup of 196%). 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 | $237 - $263 | 267% |
| Aetna | $237 - $250 | 267% |
| Healthy Blue Mcr Adv - All Other Plans | $263 | 296% |
| Medicaid / KanCare | $263 - $289 | 296% |
| Healthy Blue Mcaid | $263 | 296% |
| Wppa Providers-All Plans | $394 | 443% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Lane County Hospital in Dighton, KS, the cash price is $263.00, which matches the facility's median negotiated rate and the median amount paid by insurers. This rate is significantly higher than the Medicare benchmark of $88.91, reflecting a markup common in commercial billing structures where administrative costs and contract dynamics often inflate prices to 200% to 300% of the federal baseline. While the facility is a Critical Access Hospital owned by a Government Hospital District, the lack of specific county or state average data in this report means these comparisons cannot be made at this time.
Patients with high-deductible plans may find it financially advantageous to pay the $263.00 cash price directly, as this amount is lower than the negotiated rates some insurers might apply before deductibles are met. To maximize savings, consumers should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, which can reduce the bill by 20% to 50% if paid in full upfront. It is also important to avoid balance billing by ensuring the facility submits claims only for in-network services, and if a surprise bill arises, patients should dispute it using the No Surprises Act protections rather than paying immediately. Always verify the exact itemized charges to ensure no unbundled codes or services not rendered are included in the final invoice.