X-ray, shoulder
Facility: Stevens County Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $205
- Cash Discount Price: $236
- vs. Medicare Baseline: 2.31x 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 231% of the Medicare baseline (a markup of 131%). 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 |
|---|---|---|
| Humana | $87 | 98% |
| Aetna | $90 - $236 | 101% |
| Blue Cross Blue Shield | $133 - $140 | 150% |
| First Health - All Plans | $212 | 238% |
| Wppa - All Plans | $224 | 252% |
| Medicaid / KanCare | $236 | 265% |
Consumer Guidance & Cost Commentary
For this X-ray of the shoulder at Stevens County Hospital in Hugoton, Kansas, the cash price is $236.00, which matches the facility's gross chargemaster rate. While commercial insurance plans like Aetna and Blue Cross Blue Shield have negotiated rates ranging from $90 to $236, the cash price remains the highest single figure in this dataset. It is important to note that for patients with high-deductible plans, paying the cash price of $236.00 upfront can sometimes be more cost-effective than relying on insurance, especially if the insurer's negotiated rate exceeds the cash price or if the patient has not yet met their deductible. Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final amount owed by bypassing the administrative costs associated with insurance claims processing.
The facility's pricing is benchmarked against the Medicare rate of $88.91 for this service, showing a ratio of 2.3 times the Medicare amount. This comparison highlights that commercial rates often include significant markups due to administrative overhead and contract dynamics, whereas the Medicare rate represents a more objective baseline for the true cost of care. Although the facility is a Critical Access Hospital with a government-local ownership structure, the wide variation in negotiated rates among payers—from $87 for Humana to $236 for Medicaid/KanCare—demonstrates that network status does not guarantee a uniform price. Consumers are advised to request an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected