CMS Price Transparency Data

X-ray, shoulder

Facility: Graham County Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $147
  • Cash Discount Price: $190
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Graham County Hospital is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.65x the Medicare baseline. Located in 304 West Prout Street, Hill City, KS.
Cash / Self-Pay
$190

Average discount available for prompt cash payment at this facility.

Insurance Median
$147

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $190 (214%)
Insurance Median: $147 (165%)
Cash: $190 (214% of Medicare)
Ins. Median: $147 (165% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $118 133%
UnitedHealthcare $118 - $180 133%
Blue Cross Blue Shield $139 156%
Medicare (plans) $142 160%
Celtic Commercial-All Other Plans $157 177%
Wppa (Providers Care)-All Plans $180 202%

Consumer Guidance & Cost Commentary

For the X-ray, shoulder procedure (CPT 73030) at Graham County Hospital in Hill City, Kansas, the cash price is $190.00, which matches the facility's median negotiated rate of $190.00. This cash price is significantly higher than the state average for this service, which is $118.00, and exceeds the lowest negotiated rates found across the state. While commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $118 to $180, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying cash upfront can be more cost-effective than relying on insurance, as the administrative costs and claim processing fees embedded in negotiated rates can inflate the final bill.

Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the total cost by 20% to 50%. It is important to request a waiver of insurance submission to ensure the cash discount applies and to avoid automatic claims that might void the agreement. Additionally, while the facility is a Critical Access Hospital with government ownership, the charged amount of $190.00 is 1.7 times the Medicare benchmark of $88.91, indicating a markup relative to the federal cost baseline. Consumers are advised to review their itemized bill carefully to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 304 West Prout Street, Hill City, KS 67642
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals