X-ray, shoulder
Facility: Hodgeman County Health Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $211
- Cash Discount Price: $239
- vs. Medicare Baseline: 2.37x 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 237% of the Medicare baseline (a markup of 137%). 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 | $133 - $140 | 150% |
| UnitedHealthcare | $191 - $284 | 215% |
| Triwest - All Plans | $191 | 215% |
| Humana | $191 | 215% |
| Medicaid / KanCare | $191 - $299 | 215% |
| Aetna | $239 | 269% |
| First Health - All Plans | $269 | 303% |
| Wppa (Provdrscare) - All Plans | $284 | 319% |
| Health Partners - All Plans | $284 | 319% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash price of $239.00 is significantly lower than the gross charge of $299.00. While the facility is a Critical Access Hospital owned by the local government, patients should note that their insurance negotiated rates vary widely; for instance, Blue Cross Blue Shield plans pay a maximum of $140, whereas Medicaid/KanCare plans pay up to $299. Because the cash price matches the highest negotiated rate for some payers, patients with high-deductible plans might find paying out-of-pocket cheaper if their insurance allowed amount exceeds $239.00. It is always advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final cost.
When evaluating the value of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this code is $88.91, which serves as the objective baseline for fair pricing; commercial rates typically range from 200% to 300% of this figure, while fair pricing is generally considered to be between 120% and 150%. Although the facility's cash rate of $239.00 is higher than the Medicare rate, it aligns with the median negotiated rate of $211.00 and the median paid amount of $225.00 reported for this service. Consumers should avoid assuming that being in-network guarantees the lowest price,