X-ray, shoulder
Facility: Osborne County Memorial Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $186
- Cash Discount Price: $176
- vs. Medicare Baseline: 2.09x 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 209% of the Medicare baseline (a markup of 109%). 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 |
|---|---|---|
| UnitedHealthcare | $149 - $164 | 168% |
| Health Partners Of Kansas | $169 - $186 | 190% |
| Wppa | $186 - $205 | 209% |
| Blue Cross Blue Shield | $192 - $212 | 216% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Osborne County Memorial Hospital in Osborne, KS, the facility's cash price of $176.00 is lower than the gross charge of $206.00. This cash rate is notably lower than the state average for this service, which is $186.00. If you have a high-deductible plan, paying the cash price upfront might be more cost-effective than using insurance, as commercial negotiated rates for this code range from $149 to $212 depending on your specific insurer. For example, UnitedHealthcare plans in this network pay a negotiated rate of $149 to $164, while WPPA plans pay between $186 and $205. However, be aware that these negotiated rates often include administrative costs and may exceed the cash price if your deductible has not yet been met.
The facility's pricing is also evaluated against the Medicare benchmark, which stands at $88.91 for this procedure. The hospital's cash rate of $176.00 represents a markup of 2.1 times the Medicare amount, which is consistent with typical commercial pricing structures where rates average 200% to 300% of Medicare. To minimize costs, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full before the insurance claim is processed. Additionally, since over 80% of hospital bills contain errors, we strongly advise requesting a detailed, itemized bill to verify that no services were