CMS Price Transparency Data

X-ray, ankle

Facility: Adventist Health St Helena

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $465
Cash Discount Price: $96
vs. Medicare Baseline: 5.23x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Adventist Health St Helena is $465. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.23x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$465

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $96 (108%)

Insurance Median: $465 (523%)

Cash: $96 (108% of Medicare)

Ins. Median: $465 (523% of 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 523% of the Medicare baseline (a markup of 423%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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 Shield Bh Mcr Adv	$9 - $116	10%
Blue Shield Mcr Adv	$9 - $116	10%
Kaiser Mcr Adv	$9 - $116	10%
Tricare	$9 - $116	10%
Ah Employee Health Plan - All Plans	$10 - $208	11%
Cigna	$11 - $1,476	12%
Interplan-All Plans	$11 - $1,199	12%
Kaiser-All Other Plans	$11 - $1,513	12%
Blue Shield Epn-All Other Plans	$12 - $869	13%
Blue Shield Non-Epn	$12 - $856	13%
Western Growers-All Plans	$14 - $978	16%
Phcs-All Plans	$20 - $1,015	22%
Medi-Cal	$25	28%
Health Management Network-All Plans	$31 - $1,568	35%
Three Rivers-All Plans	$33 - $1,660	37%
Va Medi-Cal	$36	40%
Aetna	$38 - $157	43%
UnitedHealthcare	$45 - $1,176	51%
Healthnet-All Plans	$74	83%
Va Mcr - All Other Plans	$116	130%
Blue Cross Blue Shield	$131 - $175	147%
Blue Shield Behav Hlth	$180 - $830	202%
Choicecare-All Plans	$279 - $1,292	314%
Beech Street-All Plans	$299 - $1,384	336%
Galaxy Network-All Plans	$359 - $1,660	404%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $96.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.