X-ray, shoulder
Facility: Jewell County Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $264
- Cash Discount Price: $209
- vs. Medicare Baseline: 2.97x 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 297% of the Medicare baseline (a markup of 197%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $236 | 265% |
| Aetna | $250 | 281% |
| Meritain - All Plans | $250 | 281% |
| Cigna | $264 | 297% |
| Midlands Choice - All Plans | $264 | 297% |
| UnitedHealthcare | $264 | 297% |
| First Health - All Plans | $264 | 297% |
Consumer Guidance & Cost Commentary
For patients paying cash directly, the most important thing to know is that self-pay rates can often be lower than what insurance companies agree to pay. For this X-ray, shoulder procedure at Jewell County Hospital, the cash median rate is $209, which is lower than the median negotiated rate of $264 and the median paid rate of $264. This price difference suggests that individuals with high-deductible plans might save money by paying out-of-pocket upfront, provided they confirm with the hospital about "self-pay" or "prompt-pay" discounts before scheduling. It is crucial to verify that the facility will not automatically submit a claim to your insurance, as doing so could void any cash discount and result in a balance bill if the insurance allowed amount exceeds the cash price.
In the broader context of pricing, the facility's cash rate of $209 is significantly lower than the Medicare benchmark of $88.91, indicating a markup relative to the federal government's fixed reimbursement rate. While the facility is a Critical Access Hospital in Mankato, Kansas, with government local ownership, specific county or state average data was not provided in this report to make direct comparisons. However, the data shows that among the seven payers listed, rates range from $236 to $264, with Rural Carriers - All Plans charging the lowest negotiated rate of $236. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, unexpected ancillary charges or errors in the initial summary bill can still occur, making it advisable to request a full itemized audit before finalizing payment.