X-ray, hand
Facility: Memorial Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $335
- Cash Discount Price: $609
- vs. Medicare Baseline: 3.77x 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 377% of the Medicare baseline (a markup of 277%). 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 | $144 | 162% |
| Tricare | $304 | 342% |
| Humana | $304 | 342% |
| Medicare (plans) | $307 | 345% |
| Ambetter / Centene | $335 | 377% |
| Coventry - All Other Plans | $548 | 616% |
| Preferred Healthcare-All Plans | $578 | 650% |
| Health Partners Of Kansas - All Plans | $578 | 650% |
| Wppa/Providers Care-All Plans | $852 | 958% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Memorial Hospital in Abilene, KS, the cash price is $609.00, which matches the facility's median paid amount. While commercial insurance plans like Blue Cross Blue Shield and Tricare negotiate rates around $304 to $307, these figures often exceed the cash price, meaning self-pay patients could save money by paying directly. It is important to note that Medicare sets a benchmark of $88.91 for this service, and commercial rates are significantly higher than this federal baseline. Patients should verify their specific plan's deductible status before relying on insurance, as paying the negotiated rate may not be cost-effective if the patient has not yet met their out-of-pocket threshold.
To minimize potential costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront. Additionally, if a patient receives a large bill after insurance processing, they should request a detailed, itemized audit to ensure no errors, double-billing, or unbundled charges exist, as over 80% of hospital bills contain mistakes. While the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to dispute any unexpected charges in writing rather than accepting summary bills or verbal assurances. Always confirm the facility's self-pay classification before scheduling to avoid automatic claims submission that might void cash discounts.