X-ray, hand
Facility: Hodgeman County Health Center
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $185
- Cash Discount Price: $210
- vs. Medicare Baseline: 2.08x 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 208% of the Medicare baseline (a markup of 108%). 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 | $130 - $137 | 146% |
| UnitedHealthcare | $168 - $250 | 189% |
| Humana | $168 | 189% |
| Triwest - All Plans | $168 | 189% |
| Medicaid / KanCare | $168 - $263 | 189% |
| Aetna | $210 | 236% |
| First Health - All Plans | $237 | 267% |
| Wppa (Provdrscare) - All Plans | $250 | 281% |
| Health Partners - All Plans | $250 | 281% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash price is $210, which aligns exactly with the median negotiated rate and the cash median for this service. While the gross charge listed is $263, commercial payers negotiate rates ranging from $130 to $263 depending on the plan; for instance, Blue Cross Blue Shield plans pay between $130 and $137, whereas Medicaid/KanCare plans pay the full $168 to $263. It is important to note that while insurance often negotiates a rate, the cash price can sometimes be lower than the allowed amount for patients with high-deductible plans who have not yet met their out-of-pocket maximum. Additionally, this facility is a Critical Access Hospital owned by the local government, and patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially reduce the final cost.
The Medicare benchmark for this procedure is $88.91, which serves as the objective baseline for evaluating pricing markups. The facility's cash price of $210 represents a 2.1x markup compared to the Medicare rate, which is consistent with the typical range where commercial rates average 200% to 300% of Medicare, though fair pricing is often defined as 120% to 150%. Since the facility is a Critical Access Hospital in a rural area (ZIP 67854), these rates reflect the specific cost structures and wage indexes used by CMS for the region. Consumers should be aware that hospitals often issue summary bills that obscure individual charges;