X-ray, shoulder
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 73030 (CPT)
- CPT Billing Code: 73030
- Insurance Median: $529
- Cash Discount Price: $705
- vs. Medicare Baseline: 5.95x 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 595% of the Medicare baseline (a markup of 495%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $235 - $861 | 264% |
| Americas Choice Provider Network | $274 - $1,004 | 308% |
| Usa Managed Care Organization | $293 - $1,076 | 330% |
| Velocity | $293 - $1,076 | 330% |
| Quiktrip Corporation | $293 - $1,076 | 330% |
| Provider Network Of America | $293 - $1,076 | 330% |
| Multiplan-Phcs | $313 - $1,147 | 352% |
| Prime Health Services | $332 - $1,219 | 373% |
| Medincrease | $352 - $1,291 | 396% |
Consumer Guidance & Cost Commentary
For the X-ray, shoulder procedure (CPT 73030) at the Rehabilitation Hospital Of Overland Park, the cash price is $705.00, which matches the facility's median paid amount. This cash rate is significantly higher than the national Medicare benchmark of $88.91, reflecting a markup of 5.9 times the federal baseline. While the facility's negotiated rates with major payers like Blue Cross Blue Shield range from $235 to $861, these amounts are generally lower than the cash price, suggesting that for patients with high-deductible plans, paying cash upfront might not be the most cost-effective option unless the specific insurance plan's allowed amount exceeds $705.00.
Patients should be aware that commercial insurance contracts often include administrative overheads that inflate the baseline price by 20% to 40%, making the negotiated rates higher than the direct cash price in many cases. To maximize savings, individuals should verify their specific plan's allowed amount before scheduling and inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window. Additionally, if you are using insurance, ensure your provider has not submitted a claim to your insurer by default, as this could void any potential cash discount; requesting a waiver of insurance submission prior to check-in is a critical step to secure the lowest possible rate.