X-ray, shoulder
Facility: Children'S Mercy South
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $348
- Cash Discount Price: $138
- vs. Medicare Baseline: 3.91x 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 391% of the Medicare baseline (a markup of 291%). 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 |
|---|---|---|
| Medicaid / KanCare | $8 - $57 | 9% |
| Cigna | $8 - $561 | 9% |
| Healthy Blue | $8 - $226 | 9% |
| UnitedHealthcare | $8 - $542 | 9% |
| Home State Health | $9 - $198 | 10% |
| Wppa Providrs Care | $12 - $525 | 13% |
| Health Midwest Comprehensive Care | $12 - $525 | 13% |
| Healthlink | $12 - $710 | 13% |
| American Healthcare Alliance | $13 - $686 | 15% |
| Blue Cross Blue Shield | $13 - $597 | 15% |
| Quiktrip | $13 - $525 | 15% |
| Multiplan | $16 - $613 | 18% |
| Medica | $16 - $470 | 18% |
| Wellfit/Centrus | $17 - $525 | 19% |
| Centivo | $17 - $525 | 19% |
| Aetna | $17 - $549 | 19% |
| Humana | $18 - $537 | 20% |
| Orscheln | $18 - $525 | 20% |
| Nebraska Furniture Mart | $18 - $525 | 20% |
| Coxhealth Network | $20 - $597 | 22% |
| Mercy Health | $20 - $605 | 22% |
| Coventry Health Care Of Kansas | $21 - $597 | 24% |
| National Preferred Provider Network | $24 - $726 | 27% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder) at Children's Mercy South in Overland Park, KS, the facility's cash median price is $138.00, which is significantly lower than the state average of $287.00. While commercial insurance carriers negotiate rates that often exceed these cash prices, patients with high-deductible plans may find paying out-of-pocket cheaper if the insurance allowed amount surpasses the cash rate. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur from ancillary services like emergency physicians or labs. To avoid surprise costs, patients should verify their specific plan's allowed amount before scheduling and consider requesting a "waiver of insurance submission" if they intend to pay cash directly.
Patients should also be aware that commercial negotiated rates frequently include administrative markups, often ranging from 200% to 300% of the Medicare benchmark rate of $88.91 for this procedure. Although the facility's negotiated rates vary widely among payers, with the highest reaching $726, the cash price remains a strong baseline for comparison. If you choose to pay directly, ask the billing department about "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payment. Additionally, always request a full itemized bill before paying; over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered, and paying a summary bill without reviewing the line items can lead to unnecessary debt.