X-ray, shoulder
Facility: Clara Barton Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- 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 | $139 | 156% |
| 6 Degrees Health - All Plans | $171 - $256 | 192% |
| Wppa-All Plans | $195 - $292 | 219% |
| Phcs - All Plans | $220 - $328 | 247% |
| Aetna | $220 - $328 | 247% |
| UnitedHealthcare | $220 - $328 | 247% |
| Hlth Partners Of Ks-All Plans | $224 - $336 | 252% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure at Clara Barton Hospital in Hoisington, KS, the facility's cash price of $213.00 is lower than the typical negotiated rates charged to insurance plans, which range from $139 to $336 depending on the carrier. While the hospital's cash rate is competitive, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles, as the negotiated rates can exceed the cash price. Medicare serves as a reliable benchmark for this service, with a standard reimbursement rate of $88.91; the facility's cash rate represents a significant markup over this federal baseline, reflecting the administrative costs and profit margins inherent in private billing structures.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it does not automatically eliminate all potential costs if ancillary services are billed separately. If you are paying out-of-pocket, you may qualify for prompt-pay discounts by requesting a self-pay classification before your visit, which can reduce the final amount owed. Additionally, since over 80% of hospital bills contain errors, it is advisable to request a detailed, itemized statement rather than accepting a summary bill, allowing you to verify that all charges correspond to services actually rendered and to identify any unbundled codes or duplicate billing before making a payment.