CMS Price Transparency Data

X-ray, shoulder

Facility: Lafayette Regional Health Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $650
Cash Discount Price: $1,444
vs. Medicare Baseline: 7.31x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Lafayette Regional Health Center is $650. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,444. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.31x the Medicare baseline. Located in 1500 State Street, Lexington, MO.

Cash / Self-Pay

$1,444

Average discount available for prompt cash payment at this facility.

Insurance Median

$650

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $1,444 (1624%)

Insurance Median: $650 (731%)

Cash: $1,444 (1624% of Medicare)

Ins. Median: $650 (731% of 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 731% of the Medicare baseline (a markup of 631%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Corvel Corporation	$32 - $1,634	36%
Oha Network	$32 - $961	36%
United	$49 - $865	55%
Healthyblue	$50	56%
Medicaid / KanCare	$50	56%
Aetna	$51 - $1,683	57%
Amerigroup	$51	57%
Home State Health Plan	$51	57%
Unicare	$51	57%
Ambetter / Centene	$180 - $358	202%
Nhc Advantage	$183 - $365	206%
Universal Healthcare	$251 - $500	282%
Humana	$326 - $827	367%
Blue Cross Blue Shield	$367 - $1,923	413%
College Park Family Care Center	$415 - $827	467%
Oscar	$483 - $961	543%
Cigna	$551 - $1,373	620%
Wppa Providrs Care Network	$724 - $1,442	814%
Multiplan	$753 - $1,500	847%
Coventry	$770 - $1,535	866%
Coventry Kc Mo	$770 - $1,535	866%
Cco, Inc.	$820 - $1,634	922%
Focus Healthcare Mgmt, Inc	$869 - $1,731	977%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,444.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73030.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lafayette Regional Health Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73030.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.