X-ray, hip
Facility: Holton Community Hospital
Billing Code: 73502 (CPT)
- CPT Billing Code: 73502
- Insurance Median: $391
- Cash Discount Price: $353
- vs. Medicare Baseline: 4.40x 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 440% of the Medicare baseline (a markup of 340%). 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 |
|---|---|---|
| Aetna | $250 - $471 | 281% |
| UnitedHealthcare | $250 - $471 | 281% |
| Humana | $252 | 283% |
| Kansas Superior Select - All Plans | $255 | 287% |
| Preferred Health Fn Select - All Other Plans | $391 | 440% |
| Preferred Health Freedom | $391 | 440% |
| Preferred Health Professionals | $391 | 440% |
| Wppa Providers - All Plans | $447 | 503% |
| Medicaid / KanCare | $471 | 530% |
Consumer Guidance & Cost Commentary
For this X-ray of the hip at Holton Community Hospital in Holton, Kansas, the facility's cash price is $353.00, which is lower than the state average of $391.00. While many insurance plans negotiate rates that exceed this cash amount, paying out-of-pocket can sometimes be the most cost-effective option for patients with high-deductible plans, as the insurance negotiated rate often surpasses the cash price. To potentially lower your bill further, it is recommended to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final amount owed.
The Medicare benchmark for this service is $88.91, serving as a reliable baseline to evaluate the facility's pricing structure. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership, the commercial rates vary significantly by payer, ranging from $250 to $471. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still request an itemized billing audit to ensure no errors or unbundled charges exist. Always verify your specific plan's deductible status and allowed amounts before scheduling, as assuming that in-network coverage automatically offers the lowest price can lead to unexpected costs.