CMS Price Transparency Data

X-ray, shoulder

Facility: Girard Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $140
  • Cash Discount Price: $240
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Girard Medical Center is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.57x the Medicare baseline. Located in 302 North Hospital Drive, Girard, KS.
Cash / Self-Pay
$240

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

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: $240 (270%)
Insurance Median: $140 (157%)
Cash: $240 (270% of Medicare)
Ins. Median: $140 (157% 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.

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 $140 157%
Humana $140 157%
Medicare (plans) $140 157%
Ambetter / Centene $140 157%
Aetna $140 - $700 157%
Kansas Superior Select-All Plans $140 157%
UnitedHealthcare $140 - $380 157%
Multiplan-All Plans $370 416%
Uhhis-All Plans $380 427%

Consumer Guidance & Cost Commentary

For the X-ray, shoulder procedure (CPT 73030) at Girard Medical Center in Girard, KS, the facility's cash median rate is $240.00, while the median negotiated rate paid by insurance plans is $140.00. This specific service is benchmarked against the Medicare rate of $88.91, showing a markup of 1.6 times the Medicare amount. It is important to note that while commercial negotiated rates often appear lower than cash prices, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds the cash rate. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can provide further cost savings by bypassing administrative billing cycles.

The pricing data reflects a range of negotiated amounts across nine payers, with most plans settling at $140.00, though some commercial payers like Aetna and UnitedHealthcare have ranges extending up to $700.00 and $380.00 respectively. Since this facility is a Critical Access Hospital owned by a Government Hospital District, its rates are structured to comply with federal cost-basis standards rather than inflated chargemaster lists. Consumers are advised to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. By comparing the facility's rates directly to the Medicare benchmark rather than the gross charge, patients can better understand the true cost of care and avoid unnecessary financial burden.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 302 North Hospital Drive, Girard, KS 66743
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals