CMS Price Transparency Data

X-ray, hand

Facility: Lexington Memorial Hospital Inc

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $181
Cash Discount Price: $205
vs. Medicare Baseline: 2.04x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Lexington Memorial Hospital Inc is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.04x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$205

Average discount available for prompt cash payment at this facility.

Insurance Median

$181

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: $205 (231%)

Insurance Median: $181 (204%)

Cash: $205 (231% of Medicare)

Ins. Median: $181 (204% 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 204% of the Medicare baseline (a markup of 104%). 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
Amerihealth	$77 - $113	87%
Carolina Complete	$77	87%
Healthy Blue	$77	87%
Partners	$77	87%
UnitedHealthcare	$78 - $184	88%
Vaya	$78	88%
Wellcare	$78	88%
Alliance	$79	89%
Trillium	$80	90%
Medcost	$90 - $274	101%
Blue Cross Blue Shield	$111 - $178	125%
Aetna	$116 - $379	130%
Ambetter / Centene	$118	133%
Oscar	$131 - $180	147%
Cigna	$178 - $182	200%
Directnet	$242	272%
Healthgram Lexington Home Brands	$295	332%
Healthgram	$328	369%
Private Healthcare Systems	$336	378%
Beechstreet	$361	406%
Humana	$361	406%
Multiplan	$369	415%
National Provider Network	$369	415%

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 $205.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lexington Memorial Hospital Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
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.