X-ray, shoulder
Facility: Wamego Health Center
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $43
- Cash Discount Price: $228
- vs. Medicare Baseline: 0.48x 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 |
|---|---|---|
| UnitedHealthcare | $7 - $74 | 8% |
| Aetna | $8 - $77 | 9% |
| Medicaid / KanCare | $8 - $77 | 9% |
| Providrs Care | $12 - $43 | 13% |
| Tricare | $46 | 52% |
| Blue Cross Blue Shield | $184 - $194 | 207% |
Consumer Guidance & Cost Commentary
For the CPT code 73030 (X-ray, shoulder) at Wamego Health Center in Wamego, KS, the facility's cash median price of $228.00 is significantly lower than the state average for this service. While the facility's negotiated rates for commercial payers like UnitedHealthcare and Aetna range between $7 and $77 per plan, these amounts are still higher than the cash price, illustrating that paying out-of-pocket can sometimes be more cost-effective for patients with high-deductible plans. It is important to note that the facility's negotiated rates are approximately 5 times the Medicare benchmark of $88.91, which serves as the objective baseline for fair pricing. Patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary widely and do not always represent the lowest possible cost.
To minimize out-of-pocket expenses, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. These discounts bypass the administrative overhead associated with insurance claims processing and are often available even for services billed through insurance. Additionally, if you receive a bill from this facility, request a detailed, itemized statement rather than accepting a summary invoice, as over 80% of medical bills contain errors such as double-billing or unbundled codes. If you are concerned about balance billing, remember that the No Surprises Act protects you from being billed for out-of-network services at in-network facilities, so you should dispute any unexpected charges with your insurer rather than paying immediately.