CMS Price Transparency Data

X-ray, ankle

Facility: Adventist Health Tulare

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $112
Cash Discount Price: $71
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Adventist Health Tulare is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.26x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $71 (80%)

Insurance Median: $112 (126%)

Cash: $71 (80% of Medicare)

Ins. Median: $112 (126% 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.

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
Ah Employee Health Plan - All Plans	$9 - $201	10%
Blue Shield Mcare	$9 - $112	10%
Fhcn Pace Mcr Adv - All Plans	$9 - $112	10%
Incentive Hlth - All Plans	$9 - $201	10%
Medicare (plans)	$9 - $112	10%
Tricare	$9 - $112	10%
UnitedHealthcare	$9 - $754	10%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot	$9	10%
Blue Shield Epn	$11 - $329	12%
Cal Forensic Med Grp - All Plans	$11 - $146	12%
Cigna	$11 - $482	12%
Hs Interplan-All Plans	$11 - $697	12%
Blue Shield-All Other Plans	$12 - $455	13%
Healthnet Hmo/Ppo - All Other Plans	$12 - $298	13%
Blue Cross Blue Shield	$13 - $155	15%
Aetna	$22 - $137	25%
Ccipa Medi-Cal - All Plans	$25 - $47	28%
Healthnet Medi-Cal	$25 - $47	28%
Medi-Cal	$25 - $36	28%
Upn-United Physcn Ntwrk Mcal Profee Only	$25	28%
Dignity Mcal Op Only	$40	45%
Independence Op Only - All Plans	$40	45%
Dignity Mcr Op Only - All Other Plans	$112	126%
Prime Health - All Plans	$112	126%
Prison Hlthcre - All Plans	$143	161%
Bright Health - All Plans	$162	182%
Western Growers - All Plans	$319 - $479	359%
Network By Design-All Plans	$486 - $729	547%
Multiplan - All Plans	$590 - $885	664%

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 $71.
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 Tulare 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.