X-ray, hand
Facility: Sheridan County Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $188
- Cash Discount Price: $253
- vs. Medicare Baseline: 2.11x 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 211% of the Medicare baseline (a markup of 111%). 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 |
|---|---|---|
| Celtic Insurance | $153 | 172% |
| Blue Cross Blue Shield | $188 | 211% |
| UnitedHealthcare | $240 | 270% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Sheridan County Hospital in Hoxie, KS, the cash price is $253.00, which matches the facility's cash median. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rate for in-network payers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare ranges from $153 to $240. It is important to note that these negotiated rates often exceed the cash price due to administrative costs and contract structures; however, for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $253.00 upfront could result in lower total costs compared to having insurance pay a higher negotiated amount and leaving the patient responsible for the deductible.
The facility's pricing is significantly higher than the Medicare benchmark, with the gross charge of $253.00 representing a 2.1x markup over the Medicare amount of $88.91. This aligns with the typical commercial pricing dynamic where rates can average 200% to 300% of Medicare, though fair pricing is often defined as 120% to 150% of the Medicare rate. To minimize costs, patients should verify their specific plan's allowed amount before scheduling and explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full within a short window. Additionally, if you receive an itemized bill, request a full line-by-line audit to ensure no errors or unbundled charges exist, as over 80% of