X-ray, hip
Facility: Nemaha Valley Community Hospital
Billing Code: 73502 (CPT)
- CPT Billing Code: 73502
- Insurance Median: $182
- Cash Discount Price: $327
- vs. Medicare Baseline: 2.05x 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 205% of the Medicare baseline (a markup of 105%). 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 |
|---|---|---|
| Va Ccn - All Plans | $160 | 180% |
| Humana | $160 | 180% |
| Aetna | $161 - $309 | 181% |
| Blue Cross Blue Shield | $173 | 195% |
| Celtic Comm Exch - All Plans | $176 | 198% |
| Partners Direct Health - All Plans | $189 | 213% |
| Multiplan - All Plans | $327 | 368% |
| Midlands Choice - All Plans | $345 | 388% |
| Health Partners - All Plans | $345 | 388% |
Consumer Guidance & Cost Commentary
For the X-ray, hip procedure (CPT 73502) at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $327.00, which aligns with the negotiated rate for Multiplan and serves as a key benchmark for patients with high-deductible plans. While the facility's cash price is significantly higher than the Medicare amount of $88.91, it remains lower than the highest negotiated rates observed among commercial payers, such as Midlands Choice and Health Partners, which both set their ceilings at $345.00. This pricing structure suggests that for patients without insurance or those with high-deductible plans, paying the cash median directly may result in lower out-of-pocket costs compared to having insurance process the claim, as the negotiated rates for some carriers exceed the cash price.
Patients should be aware that commercial insurance contracts often create a ceiling on what providers can charge, but these negotiated rates can sometimes be inflated by administrative overhead and contract dynamics, resulting in higher final bills than cash payments. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, there is no facility rating data available to assess quality metrics. To ensure you receive the best possible price, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the $327.00 cash median. Additionally, if you have insurance, verify your specific plan's allowed amount before scheduling, as the wide variance in negotiated rates across different payers—from $160 for Va Ccn to $345 for others—means your specific coverage could significantly impact your final responsibility.