CMS Price Transparency Data

X-ray, ankle

Facility: Wilcox Memorial Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $157
Cash Discount Price: $281
vs. Medicare Baseline: 1.77x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Wilcox Memorial Hospital is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $281. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.77x the Medicare baseline. Located in 3-3420 Kuhio Highway, Lihue, HI.

Cash / Self-Pay

$281

Average discount available for prompt cash payment at this facility.

Insurance Median

$157

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: $281 (316%)

Insurance Median: $157 (177%)

Cash: $281 (316% of Medicare)

Ins. Median: $157 (177% 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
Hmsa	$17 - $112	19%
UnitedHealthcare	$17 - $156	19%
Alohacare	$25 - $180	28%
Ohana	$26 - $250	29%
Mdx	$42 - $500	47%
Uha	$48	54%
Hwmg/Hmaa	$55 - $489	62%
Pac Admin	$76 - $562	85%
Verdegard	$82 - $500	92%
Devoted	$117	132%
Hcha	$307 - $500	345%
Kaiser	$307 - $500	345%
Multiplan	$307 - $531	345%

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 $281.
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 Wilcox Memorial 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.