X-ray, shoulder
Facility: Stanton County Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $324
- Cash Discount Price: $341
- vs. Medicare Baseline: 3.64x 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 364% of the Medicare baseline (a markup of 264%). 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 | $133 - $324 | 150% |
| Healthy Blue Mcr Adv - All Other Plans | $334 | 376% |
| Healthy Blue Mcaid | $341 | 384% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Stanton County Hospital in Johnson, KS, the cash price is $341.00, which matches the facility's gross charge and the median paid by insurers. This rate is significantly higher than the Medicare benchmark of $88.91, reflecting a markup common in commercial billing where negotiated rates often average 200% to 300% of the federal baseline. While the facility is a Critical Access Hospital with government-local ownership, patients should note that commercial negotiated rates for this service range from $334 to $341 across three payers, including Blue Cross Blue Shield, which pays a maximum of $324. Because the cash price aligns with the highest negotiated amounts, paying out-of-pocket may not offer savings for those with high-deductible plans, though checking for "self-pay" or "prompt-pay" discounts before scheduling is always recommended to ensure no additional fees apply.
The facility's pricing structure suggests that the administrative costs and contract dynamics typical of in-network care are already reflected in the final billed amount, as the median negotiated payment of $329.00 is very close to the cash rate. Unlike scenarios where insurance allows a lower rate than the cash price, here the commercial ceiling is nearly identical to the self-pay option, meaning patients should verify their specific plan's deductible status before assuming insurance will reduce their out-of-pocket cost. Given that balance billing is generally prohibited for in-network services at this facility under the No Surprises Act, patients can expect the insurer to cover the negotiated amount once the deductible is met, but it is crucial to request an itemized bill to