X-ray, shoulder
Facility: Kiowa District Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $261
- Cash Discount Price: $221
- vs. Medicare Baseline: 2.94x 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 294% of the Medicare baseline (a markup of 194%). 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 |
|---|---|---|
| Tricare | $108 | 121% |
| Blue Cross Blue Shield | $139 | 156% |
| Healthchoice-All Plans | $160 | 180% |
| UnitedHealthcare | $221 - $276 | 249% |
| Health Partners Of Ks-All Plans | $243 | 273% |
| Humana | $249 | 280% |
| Gbs Insurance - All Plans | $259 | 291% |
| Multiplan-All Plans | $259 | 291% |
| Medicare (plans) | $262 | 295% |
| Triwest-All Plans | $262 | 295% |
| Aetna | $262 | 295% |
| Medicaid / KanCare | $276 | 310% |
| Providers Care (Wppa)-All Plans | $414 | 466% |
| Liberty Healthshare-All Plans | $446 | 502% |
Consumer Guidance & Cost Commentary
For this X-ray of the shoulder at Kiowa District Hospital, the cash price is $221.00, which is lower than the median negotiated rate of $259.00 and the median paid amount of $261.00. While commercial payers like UnitedHealthcare and Healthchoice-All Plans have negotiated rates ranging from $160 to $276, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds this figure. It is important to note that while the facility is a Critical Access Hospital in Kansas, the data provided does not include specific county or state average comparisons for this procedure, so the cash rate stands as the primary benchmark for self-pay patients.
Patients should be aware that insurance billing can sometimes result in higher costs due to administrative fees and negotiated rate structures that include claims processing overhead. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is still advisable to request a prompt-pay discount if you choose to pay cash upfront, as hospitals often offer reductions of 20% to 50% for immediate payment to bypass costly insurance billing cycles. If you receive a bill, always demand a full itemized statement before agreeing to pay, as summary bills may hide unbundled codes or services not rendered, and you should dispute any errors in writing rather than accepting verbal assurances.