CMS Price Transparency Data
X-ray, shoulder
Facility: Mercy Hospital Logan County
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $306
- Cash Discount Price: $448
- vs. Medicare Baseline: 3.44x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy Hospital Logan County is $306. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $448. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.44x the Medicare baseline. Located in 200 S Academy Rd, Guthrie, OK.
Cash / Self-Pay
$448
Average discount available for prompt cash payment at this facility.
Insurance Median
$306
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: $448 (504%)
Insurance Median: $306 (344%)
Cash: $448 (504% of Medicare)
Ins. Median: $306 (344% 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 344% of the Medicare baseline (a markup of 244%). 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.
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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 | $22 - $510 | 25% |
| Humana | $22 - $694 | 25% |
| Medicaid / KanCare | $22 - $260 | 25% |
| Tricare | $126 - $215 | 142% |
| Blue Cross Blue Shield | $130 - $417 | 146% |
| Cherokee Nation Health Serv Contracted [320066] | $130 - $221 | 146% |
| Cross Timbers Hospice [20098] | $130 - $221 | 146% |
| Dept Of Veteran Affairs Contracted [320106] | $130 - $221 | 146% |
| Elara Caring Aspire Hospice Contracted [320433] | $130 - $221 | 146% |
| Elara Caring Aspire Hospice [20433] | $130 - $221 | 146% |
| Halo Hcr Inc Hospice Contracted [320432] | $130 - $221 | 146% |
| Halo Hcr Inc Hospice [20432] | $130 - $221 | 146% |
| Independent Health [20197] | $130 - $221 | 146% |
| Indian Health Service Contracted [320198] | $130 - $221 | 146% |
| Kindful Hospice Contracted [320434] | $130 - $221 | 146% |
| Kindful Hospice [20434] | $130 - $221 | 146% |
| Medical Associates Health [20444] | $130 - $221 | 146% |
| Medicare (plans) | $130 - $434 | 146% |
| Mercy Hospice Okc [20252] | $130 - $221 | 146% |
| Provider Partners Health Plans Contracted [320450] | $130 - $221 | 146% |
| Qual Choice Contracted [320325] | $130 - $221 | 146% |
| Tribute Health Plan Mcr Contracted [320338] | $130 - $221 | 146% |
| UnitedHealthcare | $130 - $608 | 146% |
| Globalhealth Contracted [320145] | $133 - $226 | 150% |
| Cigna | $134 - $738 | 151% |
| Ambetter / Centene | $153 - $260 | 172% |
| Home State Health Plan Contracted [320187] | $153 - $260 | 172% |
| Novasys Contracted [320285] | $153 - $260 | 172% |
| Health Choice Contracted [320166] | $198 | 223% |
| Webtpa Contracted [320417] | $214 - $365 | 241% |
| Medica Contracted [320239] | $255 - $434 | 287% |
| Aither Health Contracted [320449] | $306 - $738 | 344% |
| Auxiant Contracted [320462] | $306 - $738 | 344% |
| Federal Medical Center Contracted [320127] | $306 - $521 | 344% |
| Healthlink Contracted [320179] | $306 - $738 | 344% |
| Healthscope Contracted [320182] | $306 - $521 | 344% |
| Mercy Benefit Admin Contracted [320251] | $306 - $738 | 344% |
| Point C Contracted [320238] | $306 - $521 | 344% |
| Preferred Health Plan Contracted [320522] | $306 - $521 | 344% |
| Quik Trip Contracted [320447] | $306 - $521 | 344% |
| Show-Me Health Administrators Contracted [320483] | $306 - $521 | 344% |
| United Medical Resources Contracted [320454] | $306 - $608 | 344% |
| Community Care Contracted [320080] | $318 | 358% |
| Osma Health Contracted [320292] | $357 - $608 | 402% |
| United Behavioral Health Contracted [320390] | $357 - $608 | 402% |
| Benefit Management Contracted [320052] | $382 - $781 | 430% |
| Globalhealth Contracted [320144] | $382 - $651 | 430% |
| Healthcare Highways Plus Contracted [320175] | $382 - $651 | 430% |
| Private Health Care Systems Contracted [320320] | $382 - $694 | 430% |
| First Health Contracted [320128] | $399 - $679 | 449% |
| Multiplan Contracted [320270] | $408 - $781 | 459% |
| Ebms Contracted [320493] | $434 - $738 | 488% |
| Imagine 360 Contracted [320494] | $434 - $738 | 488% |
| Preferred Community Choice Contracted [320311] | $434 - $738 | 488% |
| Reflect Health Contracted [320492] | $434 - $738 | 488% |
| Yuzu Health Contracted [320521] | $434 - $738 | 488% |