CMS Price Transparency Data

X-ray, shoulder

Facility: Fredonia Regional Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $183
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Fredonia Regional Hospital is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.06x the Medicare baseline. Located in 1527 Madison, Fredonia, KS.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $203 (228%)
Insurance Median: $183 (206%)
Cash: $203 (228% of Medicare)
Ins. Median: $183 (206% of 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 206% of the Medicare baseline (a markup of 106%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $100 - $140 112%
Aetna $104 - $183 117%
UnitedHealthcare $104 - $183 117%
Veterans Programs - All Plans $104 117%
Reserve National-All Plans $183 206%
Meritain-All Plans $183 206%
Cigna $183 206%

Consumer Guidance & Cost Commentary

For the CPT code 73030 (X-ray, shoulder) at Fredonia Regional Hospital in Fredonia, KS, the cash price is $203.00, which matches the facility's median negotiated rate of $183.00 and the median paid amount. While the facility is a Critical Access Hospital owned by the local government, the data does not provide specific county or state average figures for this procedure to make a direct price comparison. However, the facility's cash price is notably higher than the Medicare benchmark of $88.91, reflecting a markup of 2.1 times the Medicare rate. For patients with high-deductible plans or those without insurance, paying the cash price of $203.00 upfront may be more cost-effective than relying on insurance, as commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures.

Patients should be aware that hospitals often issue summary bills that obscure individual charges, making it difficult to identify errors or unbundled services. To protect against overcharging, consumers should request a full itemized bill showing specific CPT codes before finalizing payment, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Additionally, since this facility offers a prompt-pay discount for upfront payments, patients should explicitly ask for self-pay or prompt-pay rates prior to scheduling to avoid being automatically enrolled in insurance billing cycles that may void cash discounts. Always verify your deductible status and ensure you are not signing away rights to dispute balance billing, particularly if you are an out-of-network patient receiving care at an in-network facility.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1527 Madison, Fredonia, KS 66736
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals