CMS Price Transparency Data

X-ray, foot

Facility: Wilcox Memorial Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $158
Cash Discount Price: $329
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Wilcox Memorial Hospital is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $329. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.78x the Medicare baseline. Located in 3-3420 Kuhio Highway, Lihue, HI.

Cash / Self-Pay

$329

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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: $329 (370%)

Insurance Median: $158 (178%)

Cash: $329 (370% of Medicare)

Ins. Median: $158 (178% 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	$19 - $112	21%
UnitedHealthcare	$19 - $157	21%
Alohacare	$24 - $181	27%
Ohana	$24 - $251	27%
Mdx	$39 - $502	44%
Uha	$48	54%
Hwmg/Hmaa	$50 - $491	56%
Pac Admin	$71 - $565	80%
Verdegard	$78 - $502	88%
Devoted	$117	132%
Hcha	$314 - $502	353%
Kaiser	$314 - $502	353%
Multiplan	$314 - $534	353%

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 $329.
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 Wilcox Memorial 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.