X-ray, hand
Facility: Smith County Memorial Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $231
- Cash Discount Price: $246
- vs. Medicare Baseline: 2.60x 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 260% of the Medicare baseline (a markup of 160%). 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 | $135 | 152% |
| Medicaid / KanCare | $172 - $246 | 193% |
| Multiplan-All Plans | $221 | 249% |
| Wppa-All Plans | $231 | 260% |
| Midlands Choice-All Plans | $234 | 263% |
| UnitedHealthcare | $234 | 263% |
| Health Partners Of Ks Ppo-All Plans | $234 | 263% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Smith County Memorial Hospital in Smith Center, KS, the cash price is $246.00, which matches the facility's gross charge and the median amount paid by Medicaid / KanCare plans. While the Medicare benchmark for this service is $88.91, indicating a significant markup relative to federal rates, the cash price remains the highest figure among the payers listed. It is important to note that for patients with high-deductible plans, paying the cash price of $246.00 upfront may be more cost-effective than relying on insurance, as some commercial negotiated rates can exceed the cash price due to administrative overhead and contract dynamics. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the lowest possible rate for immediate payment.
The data shows that while Medicaid / KanCare plans negotiate a range between $172 and $246, other major payers like Blue Cross Blue Shield and Multiplan-All Plans have fixed negotiated rates of $135 and $221, respectively. Although the facility is a Critical Access Hospital owned by the local government, the specific negotiated rates for this procedure vary significantly by insurer, with some plans paying less than the cash price and others matching it exactly. Consumers should avoid accepting summary bills that obscure individual charges, as an itemized audit is the most effective way to identify errors or unbundled codes that could reduce the final bill. Furthermore, if a patient receives a balance bill from an out-of-network provider at this in-network facility, they should dispute the amount immediately rather than paying it out of fear of credit damage, as federal protections under