X-ray, hand
Facility: Wilson Medical Center
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $216
- Cash Discount Price: $203
- vs. Medicare Baseline: 2.43x 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 243% of the Medicare baseline (a markup of 143%). 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 | $135 - $270 | 152% |
| UnitedHealthcare | $143 - $251 | 161% |
| Aetna | $143 - $270 | 161% |
| Ambetter / Centene | $143 - $270 | 161% |
| Humana | $143 | 161% |
| Tricare | $143 | 161% |
| Cigna | $216 | 243% |
| Mulitplan-All Plans | $248 | 279% |
| Health Partners-All Plans | $248 | 279% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Wilson Medical Center in Neodesha, KS, the facility's cash price of $203.00 is notably lower than the average negotiated rates paid by major insurers, which range from $143 to $270 depending on the plan. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs than paying cash directly. Specifically, the cash price of $203.00 is lower than the facility's median negotiated rate of $216.00, meaning that for patients with high-deductible plans or those who have already met their deductible, paying out-of-pocket could save money compared to the insurance allowed amount. It is always advisable to ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost.
When evaluating the value of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this procedure is $88.91, and the facility's cash price of $203.00 represents a markup of 2.4 times the Medicare rate. While commercial negotiated rates typically average 200% to 300% of Medicare, fair pricing is generally considered to be between 120% and 150% of the Medicare amount. If you receive an itemized bill, review it carefully to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal