X-ray, hand
Facility: Rooks County Health Center
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $215
- Cash Discount Price: $179
- vs. Medicare Baseline: 2.42x 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 242% of the Medicare baseline (a markup of 142%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $112 | 126% |
| Celtic Mcr Adv | $112 | 126% |
| Tricare | $112 | 126% |
| Celtic Comm - All Other Plans | $123 | 138% |
| Blue Cross Blue Shield | $137 | 154% |
| Aetna | $215 | 242% |
| UnitedHealthcare | $215 | 242% |
| Preferred Benefits Admin | $215 | 242% |
| Preferred Hlthcare - All Other Plans | $227 | 255% |
| Health Partners - All Plans | $227 | 255% |
| Healthy Blue Mcaid - All Plans | $239 | 269% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Rooks County Health Center in Plainville, Kansas, the facility's negotiated rates range from $112 to $239, with a median paid amount of $215. This negotiated rate is significantly higher than the cash median of $179, illustrating how insurance administrative costs can inflate the final price for patients. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data shows that the median negotiated rate of $215 is 2.4 times the Medicare benchmark of $88.91. This markup is typical for commercial contracts, which often include administrative overhead and risk premiums that exceed the true cost of care represented by the Medicare rate.
Patients with high-deductible plans may find it financially advantageous to pay the cash price of $179 directly, as the insurance negotiated rate of $215 exceeds the cash amount. To maximize savings, individuals should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50%. It is crucial to avoid automatic claims submission; patients should sign a waiver of insurance submission to ensure the facility applies the lower cash rate rather than processing a claim that would result in the higher negotiated fee. Additionally, since over 80% of hospital bills contain errors, patients should always demand a full itemized CPT-coded statement before paying to verify that no unbundled codes or services not rendered are included in the final charge.