X-ray, shoulder
Facility: Mitchell County Hospital Health Systems
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $266
- Cash Discount Price: $252
- vs. Medicare Baseline: 2.99x 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 299% of the Medicare baseline (a markup of 199%). 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 - $280 | 100% |
| Blue Cross Blue Shield | $140 | 157% |
| Triwest Well Mark All Plans | $238 | 268% |
| First Health-All Plans | $252 | 283% |
| Pref Hlth Care Sytms Comm - All Plans | $252 | 283% |
| Aetna | $252 | 283% |
| Phc Leased Ntwrk Access - All Plans | $266 | 299% |
| Multiplan Ppo - All Plans | $266 | 299% |
| Auxiant-All Plans | $266 | 299% |
| Health Partners Ks-All Plans | $277 | 312% |
| Cigna | $277 | 312% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Mitchell County Hospital Health Systems in Beloit, KS, the cash median price is $252.00, which is lower than the facility's negotiated rate of $266.00. While the facility is a Critical Access Hospital with government local ownership, it is important to note that commercial insurance rates often exceed cash prices due to administrative overhead and contract structures. In this case, the cash price is significantly lower than the Medicare benchmark of $88.91, illustrating that commercial rates can be marked up well above the federal baseline. Patients with high-deductible plans may find paying the cash median of $252.00 more cost-effective than relying on insurance, which could result in a higher out-of-pocket expense if their deductible has not yet been met.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total bill by 20% to 50%. It is also crucial to request a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as double-billing or unbundled codes that can be corrected. Since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status and ensure no out-of-network providers are involved in their care to avoid unexpected charges.