X-ray, hip
Facility: Ashland Health Center
Billing Code: 73502 (CPT)
- CPT Billing Code: 73502
- Insurance Median: $241
- Cash Discount Price: $193
- vs. Medicare Baseline: 2.71x 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 271% of the Medicare baseline (a markup of 171%). 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 | $81 | 91% |
| Compalliance-All Plans | $193 | 217% |
| Health Partners Of Kansas-All Plans | $205 | 231% |
| Multiplan-All Plans | $236 | 265% |
| Medicaid / KanCare | $241 | 271% |
| Medica Mcare - All Plans | $241 | 271% |
| Aetna | $241 | 271% |
| Health Choice-All Plans | $241 | 271% |
| Medicare (plans) | $241 | 271% |
| Healthy Blue Mcr Adv - All Other Plans | $241 | 271% |
| UnitedHealthcare | $241 | 271% |
| Providers Care (Wppa)-All Plans | $362 | 407% |
Consumer Guidance & Cost Commentary
For CPT code 73502, an X-ray of the hip at Ashland Health Center in Ashland, Kansas, the facility's negotiated rate is $241.00, which matches the median paid amount across all payers. This rate is identical to the cash median of $193.00, meaning patients paying out-of-pocket would save $48.00 compared to the standard insurance negotiated fee. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the pricing for this service aligns with the state average rather than showing a significant markup or discount relative to regional benchmarks. Given that the cash price is lower than the negotiated rate, patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, provided they confirm the facility offers a self-pay or prompt-pay discount to ensure they are not being billed the full chargemaster gross.
The Medicare benchmark for this service is $88.91, which serves as the objective baseline for evaluating the facility's pricing markup. The commercial negotiated rate of $241.00 represents approximately 2.7 times the Medicare amount, reflecting the typical administrative overhead and contract dynamics inherent in commercial insurance billing. Although the facility's negotiated rate exceeds the Medicare benchmark, it remains consistent across twelve different payers, including Medicaid, Medicare, and major commercial carriers like UnitedHealthcare and Aetna. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is essential to verify the specific allowed amount with the insurer before scheduling to avoid unexpected costs, especially if the patient has not yet met