CMS Price Transparency Data

X-ray, foot

Facility: Good Samaritan Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $2,030
Cash Discount Price: $3,761
vs. Medicare Baseline: 22.83x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Good Samaritan Hospital is $2,030. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,761. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 22.83x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$3,761

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,030

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: $3,761 (4230%)

Insurance Median: $2,030 (2283%)

Cash: $3,761 (4230% of Medicare)

Ins. Median: $2,030 (2283% 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 2283% of the Medicare baseline (a markup of 2183%). 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
Santa Clara Family Health Plan	$24	27%
Physicians Medical Group	$25	28%
Blue Cross Blue Shield	$28 - $188	31%
Cigna	$129 - $3,611	145%
United	$182 - $1,151	205%
Blue Shield	$210	236%
Medcare Partners	$451 - $677	507%
Health Net	$701 - $1,052	788%
Nx Health Network	$1,805 - $2,708	2030%
Sutter Select	$1,805 - $2,708	2030%
Multiplan	$1,955 - $3,611	2199%
Humana	$2,105 - $3,160	2368%
First Health	$2,286 - $4,514	2571%
Healthsmart	$2,406 - $3,837	2706%
Intercontinental Corporation	$2,406 - $3,611	2706%
Pha Pacific Health Alliance	$2,406 - $3,611	2706%
Ppo Next	$2,406 - $3,611	2706%
Aetna	$4,973 - $5,074	5593%

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 $3,761.
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 Good Samaritan Hospital 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.