CMS Price Transparency Data

X-ray, foot

Facility: Nemours Children's Hospital, Delaware

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $264
Cash Discount Price: $463
vs. Medicare Baseline: 2.97x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Nemours Children's Hospital, Delaware is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $463. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.97x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.

Cash / Self-Pay

$463

Average discount available for prompt cash payment at this facility.

Insurance Median

$264

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: $463 (521%)

Insurance Median: $264 (297%)

Cash: $463 (521% of Medicare)

Ins. Median: $264 (297% 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 297% of the Medicare baseline (a markup of 197%). 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
Us Family Health Plan	$13	15%
Celtic Transplant	$57 - $463	64%
Keystone First Hlth Plan	$92 - $205	103%
Tricare	$92	103%
Celtic Transplant For De First Health	$162	182%
UnitedHealthcare	$170 - $289	191%
Wellpoint Maryland	$171	192%
Kidz Partners	$175	197%
Health Partners	$180	202%
Upmc	$183	206%
Fidelis	$185	208%
Aetna	$196 - $269	220%
Blue Cross Blue Shield	$203 - $409	228%
Priority Partners John Hopkins	$227	255%
Six Degrees Health Transplant	$232	261%
Cigna	$255 - $292	287%
Great West-One Health Plan	$255 - $292	287%
Ambetter / Centene	$264	297%
Amerihealth Caritas Delaware	$264	297%
Geisinger Health Plan	$278	313%
Integra Administrative Group	$278	313%
National Transplant Network (Ntn)	$301	339%
Six Degrees Health	$301	339%
Star Healthcare Network	$301	339%
Life Trac Solid Organ And Bmt Transplant	$324	364%
First Health Network	$440	495%
Insurance Administrators Of America	$440	495%
Interlink Transplant Network	$440	495%
Multiplan	$440	495%
Preferred Healthcare	$440	495%
Private Healthcare Systems	$440	495%
Three Rivers Provider Network	$440	495%

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 $463.
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 Nemours Children's Hospital, Delaware 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.