X-ray, shoulder
Facility: William Newton Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $91
- Cash Discount Price: $188
- vs. Medicare Baseline: 1.02x 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 | $66 | 74% |
| UnitedHealthcare | $68 - $169 | 76% |
| Ambetter / Centene | $68 - $188 | 76% |
| Blue Cross Blue Shield | $68 - $133 | 76% |
| Providrs Care Nexus | $115 | 129% |
| Providrs Care - All Other Plans | $131 | 147% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder) at William Newton Hospital in Winfield, KS, the cash price is $188.00, which matches the facility's gross charge and the median cash rate. This cash price is significantly higher than the state average for this service, as the median paid across all payers is $68.00. While commercial insurance plans like UnitedHealthcare and Ambetter / Centene negotiate rates ranging from $68 to $188, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds $188.00. It is important to note that the facility is a Critical Access Hospital with government ownership, and while the facility rating is 4, patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying the full cash price when an insurance negotiated rate is available.
To minimize 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. Since over 80% of hospital bills contain errors, it is advisable to request an itemized billing audit rather than accepting a summary bill that obscures individual charges. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their itemized statement to ensure no unbundled codes or services not rendered are included. Comparing the facility's rates to the Medicare benchmark of $88.91 reveals that the cash price represents a markup, but the negotiated rates for most payers remain closer