X-ray, shoulder
Facility: Smith County Memorial Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $203
- Cash Discount Price: $215
- vs. Medicare Baseline: 2.28x 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 228% of the Medicare baseline (a markup of 128%). 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 | $139 | 156% |
| Medicaid / KanCare | $151 - $215 | 170% |
| Multiplan-All Plans | $194 | 218% |
| Wppa-All Plans | $203 | 228% |
| Health Partners Of Ks Ppo-All Plans | $205 | 231% |
| Midlands Choice-All Plans | $205 | 231% |
| UnitedHealthcare | $205 | 231% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Smith County Memorial Hospital in Smith Center, KS, the cash price is $215.00, which matches the facility's gross charge and the median amount paid by Medicaid/KanCare plans. This cash rate is significantly higher than the Medicare benchmark of $88.91, indicating a markup of 2.3 times the federal rate. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rate of $203.00, provided they can secure a self-pay or prompt-pay discount before services are rendered.
The data shows that while Medicaid/KanCare plans pay a median of $139 to $215 depending on the specific plan, most other commercial payers, including Blue Cross Blue Shield and UnitedHealthcare, negotiate rates ranging from $194 to $215. Because the cash price aligns with the highest negotiated rates in this dataset, patients should verify their specific plan's allowed amount and ask the hospital directly about prompt-pay discounts, which can range from 20% to 50% off the billed amount. To ensure you are not overcharged, always request an itemized bill before paying and dispute any summary invoices that do not show individual CPT codes, as over 80% of hospital bills contain errors that can be corrected through a formal audit.