CMS Price Transparency Data

X-ray, foot

Facility: Sonoma Valley Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $626
  • Cash Discount Price: $701
  • vs. Medicare Baseline: 7.04x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Sonoma Valley Hospital is $626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $701. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.04x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$701

Average discount available for prompt cash payment at this facility.

Insurance Median
$626

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: $701 (788%)
Insurance Median: $626 (704%)
Cash: $701 (788% of Medicare)
Ins. Median: $626 (704% 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 704% of the Medicare baseline (a markup of 604%). 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.

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
Aetna $27 30%
First Health(Coventry)-All Plans $27 30%
Medi-Cal $35 39%
Mcal Mgd Care (Php)-All Plans $57 64%
Tricare $117 132%
Blue Cross Blue Shield $120 - $657 135%
Bright Hlth/Brand New Day Mcr Adv $120 135%
Hospice Of Marin-All Plans $120 135%
St Joseph Heritage Hltcare Comm-All Other Plans $120 135%
Veterans Admin-All Plans $120 135%
Partnership Healthplan-All Plans $122 137%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $126 142%
Cdcr Prison-All Plans $144 162%
Three Rivers (Trpn)-All Plans $144 162%
Chp - Correctional Health Partners - All Plans $156 175%
Bright Hlth/Brand New Day - All Other Plands $162 182%
Wellpath - All Plans $168 189%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $215 242%
Canopy Health Solutions-All Other Plans $215 242%
Healthnet Hmo/Ppo-All Other Plans $350 394%
Blue Shield Ppo-All Plans $569 640%
UnitedHealthcare $601 676%
Kaiser-All Plans $651 732%
Integrated Health Plan-All Plans $741 833%
Champus-All Plans $801 901%
Cigna $801 901%
Networks By Design - All Plans $801 901%
Comm Care Network(Ccn)-All Plans $851 957%
Great West-One Health Plan Ppo/Pos-All Plans $851 957%
Phcs/Multiplan/Beech St-All Plans $851 957%
Interplan-All Plans $881 991%
Bps-All Plans $901 1013%
Ppo Alliance-All Plans $901 1013%
Pref Health Networl(Phn)-All Plans $901 1013%
Meritage Medical Network Op Only Mcare $1,001 1126%
Scan Mcare-All Plans $1,001 1126%
St Joseph Heritage Hltcare Mcr Adv $1,001 1126%
Correct Care Integ Health-All Plans $1,201 1351%
Employer Direct Healthcare-All Plans $1,201 1351%
Meritage Medical Network Op Only-All Other Plans $1,261 1418%
Creative Legal Services-All Plans $1,301 1463%
Canopy Op Only $1,802 2027%
Vnpn - All Plans $1,802 2027%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals