X-ray, shoulder
Facility: Nemaha Valley Community Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $141
- Cash Discount Price: $244
- vs. Medicare Baseline: 1.59x 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 | $119 | 134% |
| Humana | $119 | 134% |
| Aetna | $120 - $230 | 135% |
| Celtic Comm Exch - All Plans | $131 | 147% |
| Blue Cross Blue Shield | $140 | 157% |
| Partners Direct Health - All Plans | $141 | 159% |
| Multiplan - All Plans | $244 | 274% |
| Health Partners - All Plans | $257 | 289% |
| Midlands Choice - All Plans | $257 | 289% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder) at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median rate is $244.00, which is notably higher than the state average of $141.00. While the hospital's negotiated rates with major payers like Aetna and Blue Cross Blue Shield range from $120 to $257, patients with high-deductible plans may find the cash price more advantageous if the insurance negotiated rate exceeds $244.00. It is important to note that commercial rates often include administrative overhead for claims processing, which can inflate the baseline price by 20% to 40% compared to direct cash payments.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass costly insurance billing cycles and administrative labor. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the gross charge of $271.00 represents a significant markup compared to the Medicare benchmark of $88.91, which serves as the objective baseline for true cost. Consumers are advised to verify their specific plan's allowed amount and check for any "prompt-pay" incentives directly with the hospital, as waiting until after receiving a large post-insurance bill often results in missing out on available cash discounts.