X-ray, shoulder
Facility: Republic County Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $319
- Cash Discount Price: $260
- vs. Medicare Baseline: 3.59x 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 359% of the Medicare baseline (a markup of 259%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $295 | 332% |
| Meritain-All Plans | $312 | 351% |
| Aetna | $312 | 351% |
| UnitedHealthcare | $319 | 359% |
| Midlands Choice-All Plans | $330 | 371% |
| Cigna | $330 | 371% |
| First Health-All Plans | $330 | 371% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Republic County Hospital in Belleville, KS, the negotiated rates paid by major insurers like UnitedHealthcare and Aetna are $319, which aligns with the facility's median negotiated amount. This rate is significantly higher than the cash price of $260, illustrating that commercial insurance contracts often include administrative overheads that inflate the baseline cost. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that cash payments can sometimes result in lower out-of-pocket costs, particularly for those with high-deductible plans where the insurance negotiated rate exceeds the cash price.
To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass the administrative layers of the insurance billing cycle. It is important to note that while the facility's negotiated rate of $319 is the standard for in-network coverage, this does not guarantee the lowest possible price, as some in-network facilities may charge substantially less. Additionally, the Medicare benchmark for this service is $88.91, which serves as a reliable baseline for evaluating the true cost of care; commercial rates often exceed this federal standard by a significant margin, so comparing your specific plan's allowed amount against the Medicare rate rather than the hospital's gross chargemaster is essential for understanding actual value.