X-ray, shoulder
Facility: Medicine Lodge Memorial Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $241
- Cash Discount Price: $254
- vs. Medicare Baseline: 2.71x 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 271% of the Medicare baseline (a markup of 171%). 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 | $203 | 228% |
| Humana | $231 | 260% |
| Aetna | $234 - $254 | 263% |
| UnitedHealthcare | $241 | 271% |
| Hpk-All Plans | $241 | 271% |
| Medicaid / KanCare | $254 | 286% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Medicine Lodge Memorial Hospital in Medicine Lodge, Kansas, the cash price is $254.00, which matches the facility's gross charge and the highest negotiated rate among payers. This cash rate is significantly higher than the Medicare benchmark of $88.91, reflecting a markup of 2.7 times the federal baseline. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rates, which range from $203 to $254 depending on the carrier. It is important to note that commercial negotiated rates often include administrative overhead for claims processing, making the upfront cash price a viable option for those who have not yet met their deductible or wish to avoid potential balance billing scenarios.
To secure the lowest possible cost, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling the appointment, as these fees can reduce the bill by 20% to 50% when paid in full upfront. Waiting until after receiving a large insurance bill to ask for a discount often results in the facility submitting a claim anyway, which voids the cash agreement and triggers standard billing cycles. Additionally, since over 80% of hospital bills contain errors, patients should always demand a full itemized CPT-coded statement rather than accepting a summary bill, allowing them to identify any unbundled codes or services not rendered. Given that the facility's cash rate exceeds the Medicare benchmark, verifying the exact allowed amount with the hospital is essential to ensure you are not paying more than necessary for this service.