X-ray, hip
Facility: Great Plains Of Sabetha
Billing Code: 73502 (CPT)
- CPT Billing Code: 73502
- Insurance Median: $227
- Cash Discount Price: $239
- vs. Medicare Baseline: 2.55x 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 255% of the Medicare baseline (a markup of 155%). 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 |
|---|---|---|
| Celtic Mcr Adv | $124 | 139% |
| Aetna | $126 - $241 | 142% |
| Celtic Comm Exchange-All Other Plans | $155 | 174% |
| Great West Healthcare-All Plans | $203 | 228% |
| UnitedHealthcare | $222 - $239 | 250% |
| Multiplan-Phcs-All Plans | $227 | 255% |
| Cigna | $227 | 255% |
| Century/Wppa/Providers-All Plans | $227 | 255% |
| Humana | $227 | 255% |
| Federated Mutual Ins-All Plans | $229 | 258% |
| Blue Cross Blue Shield | $239 | 269% |
| Medicaid / KanCare | $239 | 269% |
Consumer Guidance & Cost Commentary
For this X-ray of the hip at Great Plains Of Sabetha, the cash price is $239.00, which matches the facility's negotiated rate for Blue Cross Blue Shield and Medicaid/KanCare. While the median negotiated rate across all payers is $227.00, the cash price remains the highest figure in this dataset, suggesting that paying out-of-pocket may not be the most cost-effective option for patients with active insurance. However, for individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $239.00 could result in lower total costs compared to having insurance pay a negotiated rate that exceeds the patient's deductible threshold. It is important to verify your specific plan's deductible status before scheduling, as assuming that in-network coverage automatically provides the best financial outcome can lead to unexpected out-of-pocket expenses.
Patients should be aware that commercial insurance rates often include administrative overhead and contract markups that can exceed the true cost of care, which is reflected in the Medicare benchmark of $88.91 for this procedure. Although the facility is a Critical Access Hospital in Sabetha, KS, the data does not provide specific county or state average comparisons to contextualize these rates further. Regardless of the payer, consumers should proactively request a prompt-pay discount if paying in full upfront, as facilities often offer significant reductions to bypass costly claims processing. Additionally, if you receive a bill from an out-of-network provider at this in-network facility, you may be protected under the No Surprises Act, which prohibits balance billing for emergency or non-emergency services; in such cases, you should dispute any balance bill immediately rather than accepting it