CMS Price Transparency Data

X-ray, hip

Facility: Adventist Health Clearlake

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $678
Cash Discount Price: $307
vs. Medicare Baseline: 7.63x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Adventist Health Clearlake is $678. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $307. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.63x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$307

Average discount available for prompt cash payment at this facility.

Insurance Median

$678

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: $307 (345%)

Insurance Median: $678 (763%)

Cash: $307 (345% of Medicare)

Ins. Median: $678 (763% 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 763% of the Medicare baseline (a markup of 663%). 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	$53	60%
Medi-Cal	$53	60%
Blue Shield Mcr Adv	$178 - $180	200%
Kaiser Mcr Adv	$178 - $180	200%
Tricare	$178 - $180	200%
Blue Cross Blue Shield	$185 - $387	208%
UnitedHealthcare	$196 - $716	220%
Blue Shield Epn - All Other Plans	$297	334%
Blue Shield Non-Epn	$311	350%
Ah Employee Health Plan - All Plans	$356 - $360	400%
Aetna	$634 - $641	713%
Western Growers- All Plans	$636 - $644	715%
First Health- All Plans	$678 - $686	763%
Healthnet- All Plans	$695 - $704	782%
Foundation- All Plans	$721 - $729	811%
Health Mgmt Network- All Plans	$721 - $729	811%
Humana	$721 - $729	811%
Phcs- All Plans	$721 - $729	811%
Cigna	$763 - $772	858%
Interplan- All Plans	$763 - $772	858%
Kaiser- All Other Plans	$763 - $772	858%
Three Rivers Provider Network- All Plans	$763 - $772	858%
Partnership Mcal - All Plans	$1,399 - $1,416	1574%

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 $307.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

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 73502.
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.