X-ray, shoulder
Facility: Amberwell Atchison Association
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $389
- Cash Discount Price: $760
- vs. Medicare Baseline: 4.38x 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 438% of the Medicare baseline (a markup of 338%). 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 | $133 - $140 | 150% |
| Triwest - All Plans | $251 | 282% |
| UnitedHealthcare | $251 - $1,364 | 282% |
| Humana | $251 - $342 | 282% |
| Superior Select Mcr Adv - All Plans | $251 | 282% |
| Va Ccn - All Plans | $251 | 282% |
| Ambetter / Centene | $389 | 438% |
| Aetna | $418 | 470% |
| Cigna | $418 | 470% |
| Oscar - All Plans | $570 | 641% |
| Centrus Health Direct - All Plans | $570 | 641% |
| Multiplan - All Plans | $593 | 667% |
| Wppa Providrs Care - All Plans | $684 | 769% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at Amberwell Atchison Association in Atchison, KS, the cash price is $760.00, which matches the facility's median negotiated rate of $389.00 and the state average. While commercial payers like UnitedHealthcare and Humana have negotiated rates ranging from $251 to $1,364, the cash price remains the most transparent benchmark for patients. It is important to note that cash-pay can sometimes be cheaper for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price, though in this specific case, the cash rate aligns with the median negotiated amount. Patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket costs than the cash price.
To avoid unexpected costs, consumers should request a full itemized CPT-coded bill before paying, as summary bills often obscure individual charges or unbundled services. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the administrative overhead of insurance claims processing. If a balance bill arises from an out-of-network service, patients should not pay immediately but instead request a No Surprises Act audit to dispute the charge. Finally, comparing the facility's rates to the Medicare benchmark of $88.91 reveals the true cost baseline, showing that commercial rates are significantly higher than the federal government's fixed reimbursement rate.