CMS Price Transparency Data

X-ray, foot

Facility: Piedmont Macon North Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $122
Cash Discount Price: $227
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Piedmont Macon North Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.37x the Medicare baseline. Located in 400 Charter Boulevard, Macon, GA.

Cash / Self-Pay

$227

Average discount available for prompt cash payment at this facility.

Insurance Median

$122

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: $227 (255%)

Insurance Median: $122 (137%)

Cash: $227 (255% of Medicare)

Ins. Median: $122 (137% 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.

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
Blue Cross Blue Shield	$41 - $86	46%
Cigna	$58	65%
Medicaid / KanCare	$70 - $122	79%
Aetna	$95	107%
UnitedHealthcare	$216	243%
Phcs [10601]	$454	511%
Industry Buying Group [10840]	$492	553%
First Health [10303]	$530	596%
Novanet [10819]	$568	639%
Beechstreet [10800]	$605	680%
Multiplan [10600]	$681	766%

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 $227.
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 Piedmont Macon North Hospital 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.