CMS Price Transparency Data

X-ray, ankle

Facility: Spencer Municipal Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $237
  • Cash Discount Price: $209
  • vs. Medicare Baseline: 2.67x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Spencer Municipal Hospital is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $209. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.67x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.
Cash / Self-Pay
$209

Average discount available for prompt cash payment at this facility.

Insurance Median
$237

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: $209 (235%)
Insurance Median: $237 (267%)
Cash: $209 (235% of Medicare)
Ins. Median: $237 (267% 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 267% of the Medicare baseline (a markup of 167%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Wellmark Hmo $73 82%
Humana $76 - $265 85%
Medicare (plans) $76 85%
UnitedHealthcare $76 - $251 85%
Wellmark Ppo $80 90%
Medicaid / KanCare $85 96%
Healthpartners (All) $223 251%
Midlands Choice - Ilcc $237 267%
Midlands Choice - Morton Bldg $237 267%
Coventry - Commercial Hmo $251 282%
Avera Health Plan $265 298%
Coventry - Commercial Ppo $265 298%
First Choice Of Midwest $265 298%
Midlands Choice (All Others) $265 298%
Sanford Health $265 298%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 1St Avenue East, Spencer, IA 51301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals