X-ray, hip
Facility: Phillips County Hospital
Billing Code: 73502 (CPT)
- CPT Billing Code: 73502
- Insurance Median: $331
- Cash Discount Price: $311
- vs. Medicare Baseline: 3.72x 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 372% of the Medicare baseline (a markup of 272%). 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 | $173 - $296 | 195% |
| UnitedHealthcare | $293 - $366 | 330% |
| Medicaid / KanCare | $366 | 412% |
| Health Partners-All Plans | $366 | 412% |
Consumer Guidance & Cost Commentary
For this X-ray of the hip at Phillips County Hospital in Phillipsburg, KS, the facility's cash price of $311.00 is notably lower than the median negotiated rate of $331.00 and the highest commercial rate of $366.00 charged by UnitedHealthcare. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs than paying cash directly. If you have a high-deductible plan, paying the cash price of $311.00 upfront could save you money compared to your insurance's negotiated rate of $331.00, provided you have not yet met your deductible. It is always advisable to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce the final amount owed.
When evaluating the cost relative to the national standard, the Medicare benchmark for this service is $88.91, which serves as the objective baseline for fair pricing. The facility's cash rate of $311.00 represents a significant markup over the Medicare amount, a common practice in commercial billing where negotiated rates often average 200% to 300% of the Medicare rate. However, the commercial rates observed for this procedure, ranging from $173 to $366 across different payers, are substantially higher than the Medicare benchmark. To ensure you are receiving fair value, we recommend requesting an itemized billing audit to verify that all charges are accurate and that no services were unbundled or double-billed, as over 80% of hospital bills contain errors that