X-ray, hand
Facility: Clara Barton Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $224
- Cash Discount Price: $213
- vs. Medicare Baseline: 2.52x 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 252% of the Medicare baseline (a markup of 152%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $135 | 152% |
| 6 Degrees Health - All Plans | $171 - $256 | 192% |
| Wppa-All Plans | $195 - $292 | 219% |
| Phcs - All Plans | $220 - $328 | 247% |
| UnitedHealthcare | $220 - $328 | 247% |
| Aetna | $220 - $328 | 247% |
| Hlth Partners Of Ks-All Plans | $224 - $336 | 252% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Clara Barton Hospital in Hoisington, KS, the facility's cash price of $213.00 is notably lower than the median negotiated rate of $224.00 and the median paid amount of $220.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance plans often pay higher amounts than cash-pay options due to administrative overhead and contract dynamics. Specifically, the cash price is lower than the negotiated rates for most major payers listed, including Blue Cross Blue Shield, UnitedHealthcare, and Aetna, which range from $220 to $292. However, if a patient has a high-deductible plan that has not yet met their out-of-pocket threshold, paying the cash price of $213.00 upfront could result in significant savings compared to the insurance allowed amount, which may exceed the cash rate.
To ensure you are not overcharged, it is crucial to request a full itemized bill before paying, as summary bills often obscure individual line items and potential errors. Since over 80% of hospital bills contain mistakes, such as unbundled codes or services not rendered, you should demand a detailed CPT-coded statement to verify that charges align with the actual care provided. Additionally, if you are self-pay or have limited insurance coverage, ask the billing department about "prompt-pay" discounts, which can reduce the final amount by 20% to 50% if settled within 30 days. This facility's Medicare benchmark of $88.91 serves as a baseline for fair pricing; while the cash