X-ray, shoulder
Facility: Sheridan County Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $193
- Cash Discount Price: $261
- vs. Medicare Baseline: 2.17x 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 217% of the Medicare baseline (a markup of 117%). 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 | $158 | 178% |
| Blue Cross Blue Shield | $193 | 217% |
| UnitedHealthcare | $248 | 279% |
Consumer Guidance & Cost Commentary
For this X-ray, shoulder procedure at Sheridan County Hospital in Hoxie, KS, the cash price is $261.00, which matches the facility's median paid amount. While the hospital's negotiated rates with major payers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare range from $158 to $248, these amounts are still higher than the cash price. This is a common scenario where paying out-of-pocket can be more cost-effective than using insurance, especially for patients with high deductibles. Because the cash rate is lower than the negotiated rates, patients with self-pay options may save money by paying directly, provided they have the funds available.
The facility's pricing is also significantly higher than the Medicare benchmark of $88.91, with a ratio of 2.2 times the Medicare rate. While this markup is common in the healthcare industry, it highlights that commercial rates often exceed the federal baseline. To ensure you are getting the best possible price, we recommend asking the hospital about "self-pay" or "prompt-pay" discounts before scheduling your visit. These discounts can further reduce the final cost, and since the cash price is already competitive with the negotiated rates, requesting a prompt-pay discount could lower your bill even more. Always verify your specific plan details and ask for a written estimate before receiving care to avoid unexpected charges.