X-ray, shoulder
Facility: Cloud County Health Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $564
- Cash Discount Price: $243
- vs. Medicare Baseline: 6.34x 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 634% of the Medicare baseline (a markup of 534%). 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 |
|---|---|---|
| Aetna | $71 - $574 | 80% |
| Mpi-All Plans | $75 - $586 | 84% |
| Health Partners - All Plans | $586 | 659% |
| Pponext-All Plans | $586 | 659% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Cloud County Health Center in Concordia, KS, the facility's cash price of $243.00 is significantly lower than the state average, offering a potential savings opportunity for patients with high-deductible plans. While the facility's negotiated rates with major payers like Aetna and Mpi-All Plans range from $71 to $586, the cash price remains the most transparent baseline. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; therefore, patients with high deductibles may find paying the cash price upfront more cost-effective than relying on insurance, which could result in higher allowed amounts. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing the costly insurance claims processing cycle.
The facility's billing practices align with federal protections under the No Surprises Act, which prohibits balance billing for emergency and non-emergency services at in-network facilities, though patients should still verify network status to avoid unexpected out-of-network charges. If a patient receives an itemized bill, they should request a full, line-by-line audit to identify errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected. For context, the facility's Medicare benchmark of $88.91 serves as the objective baseline for pricing; commercial rates are often marked up significantly above this figure, so comparing the cash price to the Medicare rate provides a clearer picture of fair value than comparing it to the inflated chargemaster list price