CMS Price Transparency Data

X-ray, shoulder

Facility: Morris County Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $171
  • Cash Discount Price: $263
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Morris County Hospital is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $263. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.92x the Medicare baseline. Located in 600 N Washington St, Council Grove, KS.
Cash / Self-Pay
$263

Average discount available for prompt cash payment at this facility.

Insurance Median
$171

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: $263 (296%)
Insurance Median: $171 (192%)
Cash: $263 (296% of Medicare)
Ins. Median: $171 (192% 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
Providrs Care (Wppa)(Nexus)-All Plans $24 27%
Blue Cross Blue Shield $133 - $171 150%
Choice Care Mcr Adv-All Plans $171 192%
Coventry Mcr $171 192%
Va Ccn-All Plans $171 192%
UnitedHealthcare $171 - $438 192%
Cigna $317 357%
Aetna $392 441%
Coventry Comm-All Other Plans $394 443%
Multiplan-All Plans $394 443%

Consumer Guidance & Cost Commentary

For the X-ray, shoulder procedure (CPT 73030) at Morris County Hospital in Council Grove, Kansas, the facility's cash median price is $263.00, which is notably higher than the state average of $244.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $133 to $438, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds $263.00. It is important to note that this facility is a Critical Access Hospital with government-local ownership, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can significantly reduce out-of-pocket costs compared to standard billing cycles.

When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charge of $438.00. The Medicare amount for this code is $88.91, and the facility's cash price represents a markup of 1.9 times the Medicare rate. Patients should be aware that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price, sometimes reaching 200% to 300% of the Medicare amount. To avoid unexpected costs, consumers should request a detailed, itemized billing audit to verify that all charges are accurate and that no services were unbundled or rendered incorrectly, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 N Washington St, Council Grove, KS 66846
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals