X-ray, hand
Facility: Children'S Mercy South
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $389
- Cash Discount Price: $152
- 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 |
|---|---|---|
| UnitedHealthcare | $7 - $603 | 8% |
| Healthy Blue | $8 - $226 | 9% |
| Home State Health | $8 - $198 | 9% |
| Cigna | $8 - $624 | 9% |
| Medicaid / KanCare | $8 - $57 | 9% |
| Healthlink | $11 - $790 | 12% |
| Wppa Providrs Care | $11 - $584 | 12% |
| Health Midwest Comprehensive Care | $11 - $585 | 12% |
| American Healthcare Alliance | $12 - $763 | 13% |
| Quiktrip | $12 - $585 | 13% |
| Blue Cross Blue Shield | $13 - $665 | 15% |
| Medica | $15 - $524 | 17% |
| Multiplan | $15 - $682 | 17% |
| Aetna | $15 - $611 | 17% |
| Centivo | $16 - $584 | 18% |
| Humana | $16 - $597 | 18% |
| Orscheln | $16 - $584 | 18% |
| Wellfit/Centrus | $16 - $584 | 18% |
| Nebraska Furniture Mart | $16 - $584 | 18% |
| Mercy Health | $18 - $674 | 20% |
| Coxhealth Network | $18 - $665 | 20% |
| Coventry Health Care Of Kansas | $19 - $665 | 21% |
| National Preferred Provider Network | $22 - $808 | 25% |
Consumer Guidance & Cost Commentary
For the X-ray, hand procedure (CPT 73130) at Children's Mercy South in Overland Park, KS, the facility's cash price is $152.00, which is significantly lower than the gross charge of $317.00. While the facility's negotiated rates with insurance payers range from $7 to $808, the cash price offers a substantial alternative for patients who may not have insurance or have high deductibles. It is important to note that commercial negotiated rates often include administrative costs for claims processing, which can make them higher than the direct cash price. Patients should verify their specific plan's allowed amount, as paying out-of-pocket upfront may result in immediate savings compared to the insurance negotiated rate, provided the patient's deductible has been met or the insurance payment exceeds the cash price.
The facility's pricing is evaluated against a Medicare benchmark of $88.91, showing a variance of 4.4 times the Medicare rate. While commercial negotiated rates can sometimes exceed fair market value, the cash price of $152.00 remains a distinct option for cost-conscious consumers. To maximize savings, patients are encouraged to ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final balance by 20% to 50% when paid in full within a short window. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected to lower the total owed.