X-ray, hand
Facility: Amberwell Atchison Association
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $241
- Cash Discount Price: $471
- vs. Medicare Baseline: 2.71x 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 271% of the Medicare baseline (a markup of 171%). 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 | $130 - $137 | 146% |
| Superior Select Mcr Adv - All Plans | $155 | 174% |
| UnitedHealthcare | $155 - $845 | 174% |
| Va Ccn - All Plans | $155 | 174% |
| Triwest - All Plans | $155 | 174% |
| Humana | $155 - $212 | 174% |
| Ambetter / Centene | $241 | 271% |
| Cigna | $259 | 291% |
| Aetna | $259 | 291% |
| Oscar - All Plans | $353 | 397% |
| Centrus Health Direct - All Plans | $353 | 397% |
| Multiplan - All Plans | $367 | 413% |
| Wppa Providrs Care - All Plans | $424 | 477% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Amberwell Atchison Association in Atchison, KS, the cash price is $471.00, which matches the facility's median negotiated rate of $241.00 and the Medicare benchmark of $88.91. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. In this specific case, the cash price is significantly higher than the Medicare benchmark, meaning that for patients with high-deductible plans or those without insurance, paying the full cash price of $471.00 may be more cost-effective than relying on insurance, which could result in a higher allowed amount or out-of-pocket responsibility depending on the plan's specific terms.
To ensure you are receiving the most accurate pricing, it is crucial 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. Additionally, patients should explicitly ask about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly claims processing cycle that inflates insurance rates. While the data indicates a range of negotiated rates across 13 payers, with the lowest at $130 and the highest at $424, the most reliable method to avoid balance billing or unexpected charges is to verify your specific plan's allowed amount and confirm that the facility has classified your account as self-pay prior to scheduling.