CMS Price Transparency Data

X-ray, foot

Facility: Adventist Health Clearlake

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $728
Cash Discount Price: $381
vs. Medicare Baseline: 8.19x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Adventist Health Clearlake is $728. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $381. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 8.19x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$381

Average discount available for prompt cash payment at this facility.

Insurance Median

$728

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: $381 (429%)

Insurance Median: $728 (819%)

Cash: $381 (429% of Medicare)

Ins. Median: $728 (819% 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 819% of the Medicare baseline (a markup of 719%). 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	$35	39%
Medi-Cal	$35	39%
Blue Cross Blue Shield	$133 - $291	150%
Blue Shield Mcr Adv	$172 - $280	193%
Kaiser Mcr Adv	$172 - $280	193%
Tricare	$172 - $280	193%
UnitedHealthcare	$189 - $1,111	213%
Blue Shield Epn - All Other Plans	$193	217%
Blue Shield Non-Epn	$202	227%
Ah Employee Health Plan - All Plans	$344 - $559	387%
Aetna	$611 - $995	687%
Western Growers- All Plans	$614 - $999	691%
First Health- All Plans	$654 - $1,066	736%
Healthnet- All Plans	$671 - $1,092	755%
Foundation- All Plans	$695 - $1,132	782%
Health Mgmt Network- All Plans	$695 - $1,132	782%
Humana	$695 - $1,132	782%
Phcs- All Plans	$695 - $1,132	782%
Cigna	$736 - $1,199	828%
Interplan- All Plans	$736 - $1,199	828%
Kaiser- All Other Plans	$736 - $1,199	828%
Three Rivers Provider Network- All Plans	$736 - $1,199	828%
Partnership Mcal - All Plans	$1,350 - $2,198	1518%

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 $381.
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 Clearlake 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.