CMS Price Transparency Data

X-ray, foot

Facility: Adventist Health St Helena

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $425
Cash Discount Price: $109
vs. Medicare Baseline: 4.78x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Adventist Health St Helena is $425. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.78x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$425

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: $109 (123%)

Insurance Median: $425 (478%)

Cash: $109 (123% of Medicare)

Ins. Median: $425 (478% 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 478% of the Medicare baseline (a markup of 378%). 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	$10 - $1,442	11%
Interplan-All Plans	$11 - $1,171	12%
Kaiser-All Other Plans	$11 - $1,478	12%
Blue Shield Epn-All Other Plans	$12 - $849	13%
Blue Shield Non-Epn	$12 - $836	13%
Western Growers-All Plans	$13 - $955	15%
Phcs-All Plans	$19 - $991	21%
Medi-Cal	$24	27%
Health Management Network-All Plans	$30 - $1,532	34%
Three Rivers-All Plans	$32 - $1,622	36%
Va Medi-Cal	$35	39%
Aetna	$37 - $152	42%
UnitedHealthcare	$42 - $1,149	47%
Healthnet-All Plans	$70	79%
Va Mcr - All Other Plans	$116	130%
Blue Cross Blue Shield	$131 - $175	147%
Blue Shield Behav Hlth	$180 - $811	202%
Choicecare-All Plans	$279 - $1,261	314%
Beech Street-All Plans	$299 - $1,352	336%
Galaxy Network-All Plans	$359 - $1,622	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 $109.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73630.

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 73630.
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.