X-ray, hand
Facility: Mitchell County Hospital Health Systems
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $248
- Cash Discount Price: $235
- vs. Medicare Baseline: 2.79x 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 279% of the Medicare baseline (a markup of 179%). 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 | $89 - $261 | 100% |
| Blue Cross Blue Shield | $137 | 154% |
| Triwest Well Mark All Plans | $222 | 250% |
| Pref Hlth Care Sytms Comm - All Plans | $235 | 264% |
| First Health-All Plans | $235 | 264% |
| Aetna | $235 | 264% |
| Auxiant-All Plans | $248 | 279% |
| Multiplan Ppo - All Plans | $248 | 279% |
| Phc Leased Ntwrk Access - All Plans | $248 | 279% |
| Cigna | $258 | 290% |
| Health Partners Ks-All Plans | $258 | 290% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Mitchell County Hospital Health Systems in Beloit, KS, the cash price is $235.00, which is lower than the facility's negotiated rates of $248.00 and the median paid amount of $248.00. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that paying cash upfront may result in a lower total cost compared to using insurance, especially if their plan has a high deductible. The data indicates that the cash price is significantly lower than the gross charge of $261.00, and patients can often reduce their bill further by requesting a prompt-pay discount before scheduling, which typically offers a fee reduction of 20% to 50% for upfront payment.
It is important to note that this specific CPT code does not have a county or state average provided in the current dataset, so direct comparisons to regional pricing are not available. However, the facility's cash rate of $235.00 is notably lower than the Medicare amount of $88.91 when adjusted for the 2.8x multiplier often seen in commercial pricing, suggesting that while the cash price is higher than the base Medicare rate, it remains below the typical commercial negotiated rates seen across various payers like UnitedHealthcare and Aetna. Patients should avoid accepting summary bills and instead request a full itemized audit to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.