X-ray, hand
Facility: Oakleaf Surgical Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $86
- Cash Discount Price: $301
- vs. Medicare Baseline: 0.97x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $86 | 97% |
| Dean Health Plan | $86 | 97% |
| Group Health Cooperative Of Eau Claire | $86 | 97% |
| Healthpartners | $86 | 97% |
| Humana | $86 | 97% |
| Medica | $86 | 97% |
| Quartz Health Solutions | $86 | 97% |
| Security Health Plan Of Wi | $86 - $876 | 97% |
| Ucare Wi | $86 | 97% |
| UnitedHealthcare | $86 | 97% |
| Alliance | $216 | 243% |
Consumer Guidance & Cost Commentary
For the CPT code 73130 (X-ray, hand) at Oakleaf Surgical Hospital in Altoona, WI, the cash median rate is $301. This facility is a physician-owned Acute Care Hospital, and while the cash price is available for patients paying directly, it is important to note that commercial negotiated rates for this procedure are $86, which is lower than the cash price. In this specific case, a patient with a high-deductible plan might find that paying the $301 cash rate is more cost-effective than having their insurance pay the $86 negotiated rate if their deductible has not yet been met, as the insurance payment would not be fully covered by the deductible until the $86 is applied. However, patients should always verify their specific plan's deductible status and ask the hospital directly about any "self-pay" or "prompt-pay" discounts that could further reduce the $301 cash amount before scheduling.
The Medicare benchmarking amount for this service is $88.91, which serves as a baseline for evaluating the facility's pricing markup. While the data does not provide explicit state or county average figures for comparison, the facility's gross charge of $335 is significantly higher than the Medicare rate of $88.91. It is crucial for consumers to understand that comparing the $335 gross charge to the cash price is misleading; instead, the cash price of $301 should be compared against the Medicare rate of $88.91 to assess the true cost to the patient. If a patient receives a bill that differs from these rates, they should request an itemized billing audit to check for errors, double