X-ray, shoulder
Facility: Bob Wilson Memorial Hospital
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $206
- Cash Discount Price: $92
- vs. Medicare Baseline: 2.32x 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 232% of the Medicare baseline (a markup of 132%). 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 |
|---|---|---|
| Aetna | $73 - $239 | 82% |
| Humana | $73 - $95 | 82% |
| UnitedHealthcare | $73 - $249 | 82% |
| Kansas Health | $73 - $95 | 82% |
| Medicare (plans) | $73 - $95 | 82% |
| Centura Employee Plan | $91 | 102% |
| Blue Cross Blue Shield | $187 | 210% |
| Multiplan | $206 - $277 | 232% |
| Health Partners Of Kansas | $216 - $280 | 243% |
| Wppa | $218 - $283 | 245% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder) at Bob Wilson Memorial Hospital in Ulysses, KS, the facility's negotiated rates range from $73 to $283 across ten payers, with a median negotiated amount of $206. This median rate is notably higher than the facility's cash median of $92 and exceeds the Medicare benchmark of $88.91 by a factor of 2.3. While commercial insurance contracts often provide a ceiling on charges, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds the cash amount. It is important to verify specific allowed amounts with your insurer before scheduling, as in-network rates can vary significantly even within the same facility.
To minimize out-of-pocket costs, patients should proactively request "self-pay" or "prompt-pay" discounts before check-in, which can reduce bills by 20% to 50% by bypassing administrative claim processing fees. Since over 80% of hospital bills contain errors, consumers are advised to demand a full itemized CPT-coded statement rather than accepting summary invoices, ensuring no unbundled codes or services not rendered are charged. Additionally, while the No Surprises Act protects against balance billing for emergency care at in-network facilities, patients should still review their itemized bills carefully to dispute any unexpected charges. For this specific service, the facility's ownership as a voluntary non-profit church and its status as a Critical Access Hospital may influence its pricing structure compared to broader state or county averages.