X-ray, shoulder
Facility: Hospital District #6 Patterson Health Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $171
- Cash Discount Price: $152
- vs. Medicare Baseline: 1.92x 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.
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 | $132 - $139 | 148% |
| UnitedHealthcare | $171 - $190 | 192% |
| Providers Care (Wppa)-All Plans | $332 | 373% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's negotiated rate is $171.00, which matches the median negotiated amount for this service in the region. This rate is significantly higher than the Medicare benchmark of $88.91, reflecting a markup of 1.9 times the federal rate. While the facility is a Critical Access Hospital owned by the Government - Hospital District or Authority, patients should note that cash payments are often more economical. The cash median price is $152.00, which is lower than the negotiated rate of $171.00. For individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly can result in immediate savings compared to the insurance negotiated ceiling.
To maximize potential savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling the appointment, as these upfront payment incentives can further reduce the final cost. It is important to verify the specific discount structure with the hospital, as automatic claims submission by the facility may void any cash agreement if insurance coverage is active. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still request a full itemized bill to ensure no unbundled codes or services not rendered are included. Comparing the facility's pricing to the state average confirms that the negotiated rate of $171.00 is consistent with the median paid amount for this CPT code across the three payers listed, but the cash option remains the most direct path