X-ray, hip
Facility: Fredonia Regional Hospital
Billing Code: 73502 (CPT)
- CPT Billing Code: 73502
- Insurance Median: $215
- Cash Discount Price: $239
- vs. Medicare Baseline: 2.42x 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 242% of the Medicare baseline (a markup of 142%). 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 | $118 - $173 | 133% |
| UnitedHealthcare | $122 - $215 | 137% |
| Veterans Programs - All Plans | $122 | 137% |
| Aetna | $122 - $215 | 137% |
| Meritain-All Plans | $215 | 242% |
| Reserve National-All Plans | $215 | 242% |
| Cigna | $215 | 242% |
Consumer Guidance & Cost Commentary
For this X-ray, hip procedure at Fredonia Regional Hospital in Kansas, the cash price is $239.00, which matches the facility's median negotiated rate of $215.00 and the Medicare benchmark of $88.91. While the facility is a Critical Access Hospital with government local ownership, the cash price is significantly higher than the Medicare rate, reflecting standard commercial pricing structures. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rate of $215.00 often exceeds the cash price due to administrative overhead and contract dynamics. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront incentives can further reduce the total amount owed.
The data indicates that this specific CPT code has a wide range of negotiated rates across different payers, with amounts varying from $118 to $215.00 depending on the insurance plan. For instance, Blue Cross Blue Shield plans have negotiated rates between $118 and $173, while UnitedHealthcare and Aetna ranges extend up to $215.00. Because commercial rates can fluctuate significantly based on network tiering and administrative costs, patients should verify their specific plan's allowed amount before scheduling. If a balance bill arises from an out-of-network service at this in-network facility, the No Surprises Act may protect patients from paying the difference between the negotiated rate and the full chargemaster, provided the service falls under federal protections for emergency or non-emergency care.