X-ray, hand
Facility: Trego County Lemke Memorial Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $187
- Cash Discount Price: $191
- vs. Medicare Baseline: 2.10x 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 210% of the Medicare baseline (a markup of 110%). 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 |
|---|---|---|
| Humana | $110 | 124% |
| Tricare | $119 | 134% |
| Medicaid / KanCare | $140 - $225 | 157% |
| Va Ccn - All Plans | $140 | 157% |
| Aetna | $140 - $202 | 157% |
| UnitedHealthcare | $140 - $225 | 157% |
| Ambetter / Centene | $153 | 172% |
| Blue Cross Blue Shield | $187 | 210% |
| Health Partners - All Plans | $214 | 241% |
| Healthy Blue Mcaid - All Plans | $225 | 253% |
Consumer Guidance & Cost Commentary
For the X-ray of the hand (CPT 73130) at Trego County Lemke Memorial Hospital, the cash price is $191, which is lower than the facility's negotiated rates for most insurance plans. While the hospital's cash rate is $191, the median negotiated rate across payers is $187, meaning patients with high-deductible plans might find paying cash or using a prompt-pay discount more cost-effective than relying on insurance, which often incurs higher administrative fees. The facility, a Critical Access Hospital in Wakeeney, KS, offers a cash price that is $102.09 higher than the Medicare benchmark of $88.91, reflecting the typical markup found in commercial pricing structures where negotiated rates often average 200% to 300% of the federal baseline.
To ensure you receive the most accurate pricing, it is crucial to request an itemized bill before finalizing payment, as summary bills can obscure individual charges or unbundled codes that should be consolidated. If you choose to use insurance, be aware that while the facility has contracts with major payers like Humana and UnitedHealthcare, the allowed amounts vary significantly, with ranges from $110 to $225 depending on the specific plan. Since the facility is government-owned and located in a rural area, patients should explicitly ask about self-pay or prompt-pay discounts prior to scheduling to avoid unexpected balance billing, which is largely prohibited for emergency services under the No Surprises Act. Always verify your deductible status and request a written audit dispute if you receive a bill that appears to include services not rendered or charges that exceed the negotiated rates.