X-ray, hip
Facility: Decatur Health
Billing Code: 73502 (CPT)
- CPT Billing Code: 73502
- Insurance Median: $180
- Cash Discount Price: $180
- vs. Medicare Baseline: 2.02x 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 202% of the Medicare baseline (a markup of 102%). 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $120 | 135% |
| UnitedHealthcare | $122 - $152 | 137% |
| Humana | $123 | 138% |
| Aetna | $180 - $200 | 202% |
| Midlands Choice- All Plans | $180 | 202% |
| Medicaid / KanCare | $202 | 227% |
| Blue Cross Blue Shield | $223 | 251% |
Consumer Guidance & Cost Commentary
For this X-ray of the hip at Decatur Health in Oberlin, Kansas, the facility's cash price of $180.00 is lower than the average amount commercial insurers negotiate to pay, which sits at $180.00. While the facility's negotiated rate matches the state average, the cash price remains the most affordable option for patients without insurance or those with high-deductible plans. Because insurance billing involves administrative overhead and contract structures that often inflate costs, paying cash upfront can result in immediate savings compared to the standard negotiated rates charged to insured members.
Patients should verify if their specific insurance plan has a deductible that must be met before coverage applies, as this could lead to higher out-of-pocket costs even with in-network billing. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the total amount owed. Additionally, if you receive a bill from an out-of-network provider at this facility, you may be protected by the No Surprises Act, which prevents balance billing for emergency care and non-emergency services at in-network hospitals. Always request a full itemized bill before paying to ensure all charges are accurate and to identify any potential errors that could be disputed.