X-ray, shoulder
Facility: Community Memorial Healthcare, Inc.
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $140
- Cash Discount Price: $220
- vs. Medicare Baseline: 1.57x 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.
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 |
|---|---|---|
| Aetna | $39 - $266 | 44% |
| UnitedHealthcare | $48 - $203 | 54% |
| Blue Cross Blue Shield | $140 | 157% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Community Memorial Healthcare, Inc. in Marysville, KS, the cash price is $220.00, which matches the facility's median negotiated rate of $140.00 for in-network payers like Aetna and UnitedHealthcare. While the facility's negotiated rate of $140.00 is lower than the gross charge of $220.00, it is important to note that commercial insurance rates often include administrative overhead and contract premiums that can exceed the actual cost of care. In this specific case, the cash price of $220.00 is significantly higher than the facility's median negotiated rate, suggesting that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly might result in a higher total cost than using insurance, despite the higher gross charge. However, patients should verify if their specific plan has a deductible that would be met by this service, as paying the full negotiated rate of $140.00 could help accumulate toward that deductible.
The facility's pricing structure shows a median paid amount of $163.00 by insurers, which is higher than the cash price of $220.00, indicating that the administrative burden of processing insurance claims may be inflating the effective cost for some members. To minimize costs, patients are encouraged to ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass the costly insurance billing cycle and reduce the final bill. Additionally, since this facility is a Critical Access Hospital in