CMS Price Transparency Data

X-ray, ankle

Facility: Central Florida Lake Monroe Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $1,411
Cash Discount Price: $3,919
vs. Medicare Baseline: 15.87x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Central Florida Lake Monroe Hospital is $1,411. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,919. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 15.87x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$3,919

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,411

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: $3,919 (4408%)

Insurance Median: $1,411 (1587%)

Cash: $3,919 (4408% of Medicare)

Ins. Median: $1,411 (1587% 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 1587% of the Medicare baseline (a markup of 1487%). 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
United	$182 - $2,116	205%
Freedom Health	$226 - $339	254%
Optimum	$226 - $339	254%
Corvel Corporation	$414	466%
Prime Health	$422	475%
Careworks (Rockport Community)	$435	489%
Simply	$483 - $724	543%
Molina Healthcare	$596 - $1,505	670%
Humana	$627 - $940	705%
Evolutions	$721 - $1,082	811%
Avmed	$752 - $2,351	846%
Sunshine State Health Plan	$799 - $1,199	899%
Aetna	$940 - $1,411	1057%
Florida Health Care Plan	$1,182 - $1,773	1329%
Plotkin Health	$1,567 - $2,351	1762%
Prime Health Sheriff	$1,567 - $2,351	1762%
Multiplan	$2,351 - $3,997	2644%
Three Rivers Provider Network	$2,351 - $3,527	2644%
Ppo Next	$2,664 - $3,997	2996%
Novanet	$2,821 - $4,232	3173%

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 $3,919.
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 Central Florida Lake Monroe Hospital 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.