X-ray, shoulder
Facility: F W Huston Medical Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $318
- Cash Discount Price: $330
- vs. Medicare Baseline: 3.58x 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 358% of the Medicare baseline (a markup of 258%). 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 | $140 | 157% |
| Aetna | $310 | 349% |
| Humana | $326 | 367% |
| Cigna | $351 | 395% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at F W Huston Medical Center in Winchester, KS, the facility's cash median price of $330.00 is significantly lower than the state average, which is $413.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield, Aetna, Humana, and Cigna range from $140 to $351, these amounts are generally higher than the cash price. This pricing structure suggests that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash rate of $330.00 upfront could result in lower total costs compared to using insurance, which may trigger higher negotiated fees and subsequent deductibles.
The facility's Medicare benchmarking rate of $88.91 serves as the objective baseline for evaluating pricing, revealing that the cash price represents a markup of approximately 3.6 times the Medicare amount. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can further reduce the final bill. Given that over 80% of hospital bills contain errors, it is advisable to request a full itemized statement to verify all charges before payment, ensuring that no unbundled codes or services not rendered are included in the final invoice.