X-ray, hand
Facility: Medicine Lodge Memorial Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $240
- Cash Discount Price: $253
- vs. Medicare Baseline: 2.70x 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 270% of the Medicare baseline (a markup of 170%). 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 | $202 | 227% |
| Humana | $230 | 259% |
| Aetna | $234 - $253 | 263% |
| Hpk-All Plans | $240 | 270% |
| UnitedHealthcare | $240 | 270% |
| Medicaid / KanCare | $253 | 285% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Medicine Lodge Memorial Hospital, the cash price is $253.00, which matches the facility's gross chargemaster rate. While the median negotiated rate paid by insurance plans is $240.00, patients with high-deductible plans may find paying the full cash price of $253.00 more economical than relying on insurance, as the negotiated rate often exceeds the cash price due to administrative overhead. It is important to note that while the facility is a Critical Access Hospital in Medicine Lodge, KS, this specific data point does not include a direct comparison to state or county average rates for this procedure.
The Medicare benchmark for this service is $88.91, indicating that the commercial negotiated rate of $240.00 represents a significant markup above the federal baseline. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected ancillary services could still trigger additional charges. To minimize costs, patients should request a prompt-pay discount before scheduling, which can reduce the bill by 20% to 50% if paid in full upfront, and always demand an itemized bill to verify that no services were unbundled or rendered incorrectly.