X-ray, shoulder
Facility: Lindsborg Community Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $564
- Cash Discount Price: $432
- vs. Medicare Baseline: 6.34x 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 634% of the Medicare baseline (a markup of 534%). 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 | $139 | 156% |
| Tricare | $290 | 326% |
| Coventry Mcr Adv | $293 | 330% |
| Cigna | $524 | 589% |
| Coventry Comm-All Other Plans | $555 | 624% |
| UnitedHealthcare | $555 | 624% |
| Multiplan-All Plans | $574 | 646% |
| Phcs Preferred-All Plans | $574 | 646% |
| Health Partners -All Plans | $586 | 659% |
| Century Health-All Plans | $586 | 659% |
| Wppa-All Plans | $586 | 659% |
| Coventry Wc | $586 | 659% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Lindsborg Community Hospital, the cash median price is $432.00, which is lower than the facility's negotiated rate of $574.00. This specific service is priced at 6.3% above the Medicare benchmark of $88.91, indicating a markup consistent with commercial pricing structures where negotiated rates often exceed cash prices. While the facility is a Critical Access Hospital in Lindsborg, KS, serving the 67456 zip code, the data provided does not include specific county or state average comparisons for this procedure. However, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $432.00, as paying out-of-pocket could result in immediate savings compared to the standard in-network allowed amount.
To minimize costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full upfront. It is important to request an itemized billing audit before finalizing payment, as summary bills often obscure individual charges and may contain unbundled codes or services not rendered. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still confirm their deductible status before scheduling, as high negotiated rates may still apply if the deductible has not been met. Always compare the facility's allowed amount against Medicare benchmarks rather than the gross chargemaster to understand the true cost of care.