X-ray, hand
Facility: Ellsworth County Medical Center
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $155
- Cash Discount Price: $172
- vs. Medicare Baseline: 1.74x 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 |
|---|---|---|
| Healthy Blue Mcr Adv | $81 | 91% |
| Va Ccn-All Plans | $81 | 91% |
| Humana | $81 - $163 | 91% |
| Triwest -All Plans | $81 | 91% |
| UnitedHealthcare | $112 - $172 | 126% |
| Blue Cross Blue Shield | $128 - $135 | 144% |
| Aetna | $155 | 174% |
| First Health - All Plans | $155 | 174% |
| Cigna | $163 | 183% |
| Healthy Blue Mcaid- All Other Plans | $172 | 193% |
| Medicaid / KanCare | $172 | 193% |
| Coventry Mcaid-All Plans | $172 | 193% |
| Providers Care-Wppa-All Plans | $258 | 290% |
Consumer Guidance & Cost Commentary
For the X-ray of the hand (CPT 73130) at Ellsworth County Medical Center in Ellsworth, Kansas, the cash price is $172.00, which matches the facility's negotiated rate with UnitedHealthcare and the gross charge. This cash price is significantly higher than the state average for this procedure, indicating that patients paying out-of-pocket may face elevated costs compared to regional norms. While the facility is a Critical Access Hospital with a Proprietary ownership structure, the lack of a lower cash rate suggests that the administrative overhead and lack of competitive pressure in this specific market area contribute to the final price. Patients should be aware that while insurance plans like Humana and UnitedHealthcare negotiate rates ranging from $81 to $172, these amounts often exceed the cash price, meaning paying directly could sometimes result in higher out-of-pocket expenses depending on the specific plan's negotiated ceiling.
It is important to note that the median amount paid by insurance payers is $133.00, which is lower than the cash price, but this does not guarantee a lower total cost for the patient. Many commercial plans, such as Aetna and First Health, have negotiated rates of $155.00, which are higher than the cash price of $172.00, suggesting that for patients with high-deductible plans, paying the cash price might be more economical if the insurance allowed amount exceeds the cash rate. Additionally, the facility offers a prompt-pay discount mechanism where paying the bill upfront can reduce the cost, though the specific discount percentage is not listed in the data. Patients are encouraged to request a self-pay classification before scheduling to avoid automatic claims