X-ray, hand
Facility: Nemaha Valley Community Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $138
- Cash Discount Price: $241
- vs. Medicare Baseline: 1.55x 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.
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 |
|---|---|---|
| Va Ccn - All Plans | $118 | 133% |
| Humana | $118 | 133% |
| Aetna | $119 - $228 | 134% |
| Celtic Comm Exch - All Plans | $130 | 146% |
| Blue Cross Blue Shield | $137 | 154% |
| Partners Direct Health - All Plans | $139 | 156% |
| Multiplan - All Plans | $241 | 271% |
| Health Partners - All Plans | $255 | 287% |
| Midlands Choice - All Plans | $255 | 287% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Nemaha Valley Community Hospital in Seneca, KS, the cash price is $241.00, which is lower than the facility's negotiated rates with most major payers. While the median negotiated amount across nine payers is $139.00, this figure represents what insurance companies pay after applying their own deductibles and copays; for patients with high-deductible plans, paying the cash price of $241.00 upfront may actually be more cost-effective than relying on insurance, as the insurer's allowed amount could exceed the cash rate. It is important to note that the facility's cash rate is significantly higher than the Medicare benchmark of $88.91, which serves as the federal baseline for true cost, indicating that commercial rates include substantial administrative markups.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected ancillary services or out-of-network providers could still result in surprise bills if not carefully reviewed. To avoid these issues, always request a full itemized bill before paying, as summary invoices often hide unbundled charges or services not rendered. Additionally, since this facility is a Critical Access Hospital with a voluntary non-profit ownership structure, you should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full within 30 days can often reduce the final amount owed. Given that over 80% of hospital bills contain errors, it is advisable to dispute any discrepancies in writing rather than accepting the initial invoice.