X-ray, shoulder
Facility: Great Plains Of Sabetha
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $214
- Cash Discount Price: $223
- vs. Medicare Baseline: 2.41x 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 241% of the Medicare baseline (a markup of 141%). 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 | $112 - $120 | 126% |
| Aetna | $113 - $232 | 127% |
| Celtic Comm Exchange-All Other Plans | $140 - $150 | 157% |
| Great West Healthcare-All Plans | $183 - $196 | 206% |
| UnitedHealthcare | $200 - $230 | 225% |
| Multiplan-Phcs-All Plans | $204 - $218 | 229% |
| Humana | $204 - $218 | 229% |
| Cigna | $204 - $218 | 229% |
| Century/Wppa/Providers-All Plans | $204 - $218 | 229% |
| Federated Mutual Ins-All Plans | $206 - $221 | 232% |
| Medicaid / KanCare | $215 - $230 | 242% |
| Blue Cross Blue Shield | $215 - $230 | 242% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Great Plains Of Sabetha in Sabetha, Kansas, the cash price is $223.00, which matches the facility's cash median. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. In this case, the median negotiated rate across payers is $214.00, meaning patients with high-deductible plans or those who have met their deductible might actually save money by paying the cash price of $223.00 rather than relying on insurance, which could result in a higher allowed amount. It is crucial to verify your specific plan's deductible status and allowed amounts before scheduling, as assuming that in-network coverage automatically provides the lowest cost can lead to unexpected out-of-pocket expenses.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $88.91 for this service. The cash price of $223.00 represents a significant markup over the Medicare rate, illustrating how commercial rates can differ substantially from the federal baseline. While the data does not provide specific county or state average comparisons for this exact code, the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, including emergency care and non-emergency ancillary services. If you receive a bill that exceeds the allowed amount for an in-network service, you should request a formal itemized audit to identify potential errors, such as unbundled codes or services not rendered, and dispute any balance billing claims with your insurer rather