X-ray, hand
Facility: Decatur Health
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $308
- Cash Discount Price: $364
- vs. Medicare Baseline: 3.46x 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 346% of the Medicare baseline (a markup of 246%). 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 | $176 | 198% |
| Wppa/Providrs Care- All Plans | $243 | 273% |
| UnitedHealthcare | $247 - $308 | 278% |
| Humana | $249 | 280% |
| Aetna | $364 - $404 | 409% |
| Midlands Choice- All Plans | $364 | 409% |
| Medicaid / KanCare | $408 | 459% |
Consumer Guidance & Cost Commentary
For the X-ray of the hand (CPT 73130) at Decatur Health in Oberlin, Kansas, the cash price is $364.00, which aligns with the median negotiated rate of $308.00 for in-network payers like UnitedHealthcare and Aetna. While the facility's cash price is higher than the state average of $364.00, it is important to note that paying out-of-pocket can sometimes be more cost-effective for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price. Since the cash price matches the state median, patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
Patients should be aware that commercial insurance rates often include administrative overhead, which can inflate the baseline price by 20% to 40% compared to the true cost of care. To avoid unexpected balance billing or errors, consumers should request a full itemized bill before paying and dispute any charges that do not match the CPT code or services rendered. Additionally, if you are paying directly, ask the hospital about prompt-pay discounts, which can reduce the bill by 20% to 50% when paid in full upfront, bypassing the costly insurance claims cycle.