X-ray, shoulder
Facility: St Luke Hospital & Living Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $179
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.01x 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 201% of the Medicare baseline (a markup of 101%). 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 |
|---|---|---|
| Bluestem Pace | $178 | 200% |
| Kansas Department Of Health And Environment | $178 | 200% |
| Humana | $178 | 200% |
| Blue Cross Blue Shield | $178 | 200% |
| UnitedHealthcare | $178 | 200% |
| Va Ccn | $178 | 200% |
| Ambetter / Centene | $180 | 202% |
Consumer Guidance & Cost Commentary
For this X-ray, shoulder procedure at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rates are consistent across all seven payers, ranging from $178 to $180. This price point is significantly higher than the Medicare benchmark of $88.91, which serves as the federal baseline for healthcare costs. While the facility is a Critical Access Hospital owned by a Government Hospital District, the commercial rates reflect standard administrative overhead and contract dynamics. Patients should note that cash-pay options are not listed for this service, but it is always advisable to ask the billing department directly about "self-pay" or "prompt-pay" discounts, which can sometimes reduce the final amount owed.
When evaluating costs, it is important to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster, as the latter often inflates the perceived savings of a discount. Although the data does not provide specific cash or state/county average figures for this code, the $178–$180 negotiated rate represents a substantial markup over the Medicare rate of $88.91. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the full negotiated rate upfront may be more cost-effective than relying on insurance, which could result in higher out-of-pocket expenses if the deductible is not satisfied. Always verify your specific plan's allowed amount and deductible status before scheduling to ensure you are aware of your financial responsibility.