CMS Price Transparency Data

X-ray, shoulder

Facility: Lincoln County Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $140
  • Cash Discount Price: $201
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Lincoln County Hospital is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $201. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.57x the Medicare baseline. Located in 624 N Second, Lincoln, KS.
Cash / Self-Pay
$201

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $201 (226%)
Insurance Median: $140 (157%)
Cash: $201 (226% of Medicare)
Ins. Median: $140 (157% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

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 $140 157%

Consumer Guidance & Cost Commentary

For this X-ray, shoulder procedure at Lincoln County Hospital in Lincoln, KS, the cash price of $201.00 is notably higher than the state average for this service. While the facility's negotiated rate with Blue Cross Blue Shield is $140.00, patients should be aware that cash payments can sometimes be more cost-effective if their insurance plan has a high deductible or if the negotiated rate exceeds the cash price. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible balance can result in significant out-of-pocket costs. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront, bypassing the administrative overhead associated with insurance claims.

When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charge of $224.00. The Medicare amount for this code is $88.91, and the facility's cash rate represents a markup of 1.6 times the Medicare rate. This comparison helps identify the true cost basis of the service, as commercial rates often include administrative layers that inflate the baseline price. To ensure you are not overpaying, request a detailed, itemized bill before finalizing payment to check for errors, unbundled codes, or services that were not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected through a formal written audit dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 624 N Second, Lincoln, KS 67455
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals