X-ray, hand
Facility: William Newton Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $68
- Cash Discount Price: $181
- vs. Medicare Baseline: 0.76x 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.
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 |
|---|---|---|
| Triwest- All Plans | $61 - $66 | 69% |
| Ambetter / Centene | $63 - $188 | 71% |
| UnitedHealthcare | $63 - $169 | 71% |
| Blue Cross Blue Shield | $63 - $130 | 71% |
| Providrs Care Nexus | $106 - $115 | 119% |
| Providrs Care - All Other Plans | $122 - $131 | 137% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at William Newton Hospital in Winfield, KS, the cash price of $181.00 is identical to the facility's median negotiated rate of $181.00, which also matches the cash median. This suggests that for patients without insurance, paying out-of-pocket may be the most cost-effective option, especially if their insurance plan has a high deductible or if the negotiated rate for their specific plan exceeds the cash price. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative processing fees.
The data indicates that commercial payers negotiate rates ranging from $61 to $188, with the median paid amount across all plans being $68.00, which is substantially lower than the cash price. However, because the cash price equals the facility's gross charge, patients should be aware that balance billing is a risk if they receive care from out-of-network providers or ancillary services not covered by their contract, potentially leading to unexpected bills for the difference between the allowed amount and the full charge. To avoid this, consumers should request an itemized bill before paying and dispute any errors, as over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered. Comparing these rates to the Medicare benchmark of $88.91 reveals a significant markup, highlighting the importance of understanding that commercial rates often exceed the federal cost baseline due to administrative overhead and contract dynamics.