CMS Price Transparency Data

X-ray, ankle

Facility: Adventist Health Clearlake

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $751
Cash Discount Price: $390
vs. Medicare Baseline: 8.45x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Adventist Health Clearlake is $751. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 8.45x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$390

Average discount available for prompt cash payment at this facility.

Insurance Median

$751

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: $390 (439%)

Insurance Median: $751 (845%)

Cash: $390 (439% of Medicare)

Ins. Median: $751 (845% 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 845% of the Medicare baseline (a markup of 745%). 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
Bc Managed Mcal	$36	40%
Medi-Cal	$36	40%
Blue Cross Blue Shield	$133 - $300	150%
Blue Shield Mcr Adv	$175 - $289	197%
Kaiser Mcr Adv	$175 - $289	197%
Tricare	$175 - $289	197%
Blue Shield Epn - All Other Plans	$193	217%
UnitedHealthcare	$193 - $1,146	217%
Blue Shield Non-Epn	$202	227%
Ah Employee Health Plan - All Plans	$350 - $577	394%
Aetna	$623 - $1,027	701%
Western Growers- All Plans	$626 - $1,030	704%
First Health- All Plans	$667 - $1,099	750%
Healthnet- All Plans	$684 - $1,127	769%
Foundation- All Plans	$709 - $1,168	797%
Health Mgmt Network- All Plans	$709 - $1,168	797%
Humana	$709 - $1,168	797%
Phcs- All Plans	$709 - $1,168	797%
Cigna	$751 - $1,237	845%
Interplan- All Plans	$751 - $1,237	845%
Kaiser- All Other Plans	$751 - $1,237	845%
Three Rivers Provider Network- All Plans	$751 - $1,237	845%
Partnership Mcal - All Plans	$1,376 - $2,267	1548%

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 $390.
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 Clearlake 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.