X-ray, hand
Facility: Hiawatha Community Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $367
- Cash Discount Price: $471
- vs. Medicare Baseline: 4.13x 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 413% of the Medicare baseline (a markup of 313%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $130 - $137 | 146% |
| UnitedHealthcare | $174 - $405 | 196% |
| Aetna | $174 - $381 | 196% |
| Humana | $176 | 198% |
| Ambetter / Centene | $209 | 235% |
| Centrus Health Direct - All Plans | $353 | 397% |
| Oscar - All Plans | $353 | 397% |
| Preferred Hlth - All Plans | $424 | 477% |
| Cigna | $447 | 503% |
| Wppa Providrs Care - All Plans | $447 | 503% |
| Midlands Choice - All Plans | $457 | 514% |
| Multiplan - All Plans | $457 | 514% |
| Healthy Blue Mcaid - All Plans | $471 | 530% |
Consumer Guidance & Cost Commentary
For the X-ray of the hand (CPT 73130) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $471.00, which matches the facility's gross chargemaster rate. This cash price is significantly higher than the state average for this service, as indicated by the 4.1x multiplier relative to the Medicare benchmark of $88.91. While commercial insurance plans like Blue Cross Blue Shield and UnitedHealthcare negotiate rates ranging from $130 to $405, these negotiated amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the full cash price of $471.00 upfront may result in lower out-of-pocket costs compared to the insurance allowed amount, provided the patient's deductible has not been met.
Patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur from ancillary services or if a waiver is signed incorrectly. To ensure accuracy, consumers should request a full itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. Given that over 80% of hospital bills contain errors, disputing any discrepancies in writing with the billing supervisor is the most effective way to avoid unnecessary debt.