X-ray, hand
Facility: Regional Medical Center
Billing Code: 73130 (CPT)
- CPT Billing Code: 73130
- Insurance Median: $870
- Cash Discount Price: $273
- vs. Medicare Baseline: 9.79x 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 979% of the Medicare baseline (a markup of 879%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 979% |
Consumer Guidance & Cost Commentary
Regional Medical Center in Manchester, Iowa, offers a CPT 73130 X-ray of the hand with a cash median price of $273 and a negotiated rate of $870 from Medical Associates Health Plan - Tri. While the cash price is significantly lower than the facility's gross charge of $341, patients should be aware that the negotiated rate exceeds the cash amount, which can be advantageous for those with high-deductible plans where the insurance allowed amount might surpass the direct cash cost. It is important to verify if the facility offers self-pay or prompt-pay discounts before scheduling, as paying upfront can sometimes result in a fee reduction that bypasses the administrative overhead associated with insurance billing cycles.
For patients concerned about balance billing or unexpected charges, it is recommended to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Although this specific procedure has a single payer with a uniform rate of $870, patients should compare the facility's pricing against state and county averages to ensure fair value, noting that commercial negotiated rates often average 200% to 300% of Medicare rates while fair pricing is typically defined as 120% to 150%. If a surprise bill arises, patients should avoid signing away their rights via consent waivers and instead dispute the charge in writing to protect against out-of-network balance billing, even though the No Surprises Act generally protects emergency care at in-network facilities.