X-ray, shoulder
Facility: Ellsworth County Medical Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $159
- Cash Discount Price: $177
- vs. Medicare Baseline: 1.79x 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 | $83 | 93% |
| Humana | $83 - $168 | 93% |
| Triwest -All Plans | $83 | 93% |
| Va Ccn-All Plans | $83 | 93% |
| UnitedHealthcare | $115 - $177 | 129% |
| Blue Cross Blue Shield | $132 - $139 | 148% |
| First Health - All Plans | $159 | 179% |
| Aetna | $159 | 179% |
| Cigna | $168 | 189% |
| Healthy Blue Mcaid- All Other Plans | $177 | 199% |
| Coventry Mcaid-All Plans | $177 | 199% |
| Medicaid / KanCare | $177 | 199% |
| Providers Care-Wppa-All Plans | $266 | 299% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure at Ellsworth County Medical Center in Ellsworth, KS, the cash price is $177.00, which matches the facility's negotiated rate with UnitedHealthcare and several other payers. This cash price is significantly higher than the state average for this service, indicating that paying out-of-pocket may not be the most cost-effective option for patients with high-deductible plans. While the cash rate is lower than the gross chargemaster of $177.00, it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate might be necessary if the deductible has not been met, whereas paying cash upfront could potentially result in a lower out-of-pocket expense if the insurance allowed amount exceeds the cash price.
The facility's negotiated rates range from $83.00 to $266.00 across 13 different payers, with a median negotiated rate of $159.00. This median is lower than the cash price, suggesting that for patients with active insurance coverage, utilizing their plan may reduce costs compared to paying cash. However, patients should be aware of balance billing risks if they receive care from out-of-network providers or ancillary services not covered by their plan, which could lead to unexpected bills for the difference between the allowed amount and the full charge. Additionally, patients should request a detailed, itemized bill to identify any errors, such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies. Finally, patients should inquire about prompt-pay discounts