X-ray, shoulder
Facility: Wilson Medical Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $222
- Cash Discount Price: $209
- vs. Medicare Baseline: 2.50x 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 250% of the Medicare baseline (a markup of 150%). 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 | $139 - $278 | 156% |
| Humana | $147 | 165% |
| UnitedHealthcare | $147 - $259 | 165% |
| Aetna | $147 - $278 | 165% |
| Tricare | $147 | 165% |
| Ambetter / Centene | $147 - $278 | 165% |
| Cigna | $222 | 250% |
| Mulitplan-All Plans | $256 | 288% |
| Health Partners-All Plans | $256 | 288% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure at Wilson Medical Center in Neodesha, KS, the cash price is $209, which is lower than the facility's gross charge of $278. While insurance companies like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from $147 to $278, patients with high-deductible plans might find paying cash directly cheaper if their insurance allowed amount exceeds the cash price. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the actual cost of care, which is why comparing these rates to the Medicare benchmark of $88.91 reveals the true cost basis for this service.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected charges can still occur if ancillary services are out-of-network. To avoid surprises, always request a full itemized bill before paying, as summary invoices may hide unbundled codes or services not rendered. Additionally, since hospitals often offer prompt-pay discounts for upfront payment, you should ask the billing department about self-pay rates or prompt-pay incentives before scheduling your visit to ensure you are not paying the highest possible amount.