X-ray, hip
Facility: Hiawatha Community Hospital
Billing Code: 73502 (CPT)
- CPT Billing Code: 73502
- Insurance Median: $338
- Cash Discount Price: $434
- vs. Medicare Baseline: 3.80x 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 380% of the Medicare baseline (a markup of 280%). 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 |
|---|---|---|
| Aetna | $161 - $351 | 181% |
| UnitedHealthcare | $161 - $373 | 181% |
| Humana | $162 | 182% |
| Blue Cross Blue Shield | $165 - $173 | 186% |
| Ambetter / Centene | $193 | 217% |
| Centrus Health Direct - All Plans | $326 | 367% |
| Oscar - All Plans | $326 | 367% |
| Preferred Hlth - All Plans | $391 | 440% |
| Cigna | $412 | 463% |
| Wppa Providrs Care - All Plans | $412 | 463% |
| Multiplan - All Plans | $421 | 474% |
| Midlands Choice - All Plans | $421 | 474% |
| Healthy Blue Mcaid - All Plans | $434 | 488% |
Consumer Guidance & Cost Commentary
For the X-ray, hip procedure (CPT 73502) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $434.00, which matches the facility's gross charge and the state median for this service. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. For instance, the median negotiated rate across payers is $338.00, yet several carriers like Cigna and WPPA Providers Care have fixed negotiated rates of $412.00, which are higher than the cash price. This illustrates that for patients with high-deductible plans or those seeking immediate payment, paying cash or utilizing a prompt-pay discount may result in lower out-of-pocket costs compared to relying on insurance reimbursement, especially when the insurer's allowed amount does not cover the full negotiated rate.
The facility's pricing is anchored by a Medicare benchmark of $88.91, which serves as the objective baseline for evaluating markup under federal cost-basis standards. Commercial rates at this location range widely, from $161.00 with Aetna and UnitedHealthcare up to $434.00 with Healthy Blue MCAID, reflecting the variability in payer contracts and network tiering. It is important to verify specific plan details before scheduling, as assuming that being in-network guarantees the lowest price can lead to unexpected costs if the deductible has not been met or if the specific carrier has a higher ceiling rate. Consumers are encouraged to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts