X-ray, shoulder
Facility: Wichita County Health Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $366
- Cash Discount Price: $321
- vs. Medicare Baseline: 4.12x 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 412% of the Medicare baseline (a markup of 312%). 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 |
|---|---|---|
| Medicaid / KanCare | $331 | 372% |
| UnitedHealthcare | $401 | 451% |
Consumer Guidance & Cost Commentary
For the X-ray of the shoulder at Wichita County Health Center in Leoti, Kansas, the facility's cash price of $321.00 is lower than the median negotiated rate of $366.00 and the median paid amount of $331.00. While Medicaid/KanCare members pay $331.00 and UnitedHealthcare members pay $401.00, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that the cash price is also lower than the Medicare benchmark of $88.91 when adjusted for the facility's specific context, though the direct comparison here highlights that paying out-of-pocket can sometimes result in a lower total than what insurance plans negotiate for this service.
This facility, a Critical Access Hospital owned by the local government, has two payers with identical low and high rates, indicating a lack of variation in pricing for these specific plans. When reviewing your bill, ensure you request an itemized statement rather than accepting a summary invoice, as hospitals often use broad categories to obscure individual charges. If you receive a bill, always ask about prompt-pay discounts, which can reduce costs by 20% to 50% if paid upfront, and verify that no services were unbundled or incorrectly charged before finalizing payment.