X-ray, hand
Facility: Susan B Allen Memorial Hospital
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $554
- Cash Discount Price: $142
- vs. Medicare Baseline: 6.23x 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 623% of the Medicare baseline (a markup of 523%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 394% |
| Providrs Care | $757 | 851% |
Consumer Guidance & Cost Commentary
For this X-ray of the hand at Susan B Allen Memorial Hospital in El Dorado, KS, the cash price is $142.00, which is significantly lower than the facility's gross charge of $218.00. While the facility's negotiated rates with UnitedHealthcare and Providrs Care are $350.00 and $757.00 respectively, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates can exceed the out-of-pocket cost of paying cash upfront. To secure the lowest possible rate, it is recommended to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling the service, as these incentives can reduce the final bill.
When comparing pricing against the broader healthcare landscape, the cash price of $142.00 is notably lower than the median negotiated rate of $554.00, suggesting that paying out-of-network or directly to the facility could save money in this specific case. It is important to note that the Medicare amount for this service is $88.91, and the facility's pricing is 6.2 times the Medicare benchmark. Because Medicare rates represent a scientifically validated baseline for the true cost of care, comparing your potential out-of-pocket costs to this figure helps identify if the facility's pricing is reasonable. If you receive a bill that exceeds the cash price or Medicare amount, you should request an itemized billing audit to verify that no errors, unbundled codes, or services not rendered have inflated your total.