CMS Price Transparency Data

X-ray, foot

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $65
Cash Discount Price: $100
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at St Anthony Regional Hospital & Nursing Home is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.73x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $100 (112%)

Insurance Median: $65 (73%)

Cash: $100 (112% of Medicare)

Ins. Median: $65 (73% 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
Aetna	$36 - $90	40%
Medica Mcr - All Plans	$36	40%
UnitedHealthcare	$36 - $272	40%
Va Ccn - All Plans	$36	40%
Wellpoint Mcr Adv	$36	40%
Ia Total Care Mcr	$37	42%
Ia Total Care Mcaid	$41	46%
Molina Mcaid - All Plans	$42	47%
Wellmark Hmo	$60	67%
Wellmark Ppo-All Other Plans	$65	73%
Humana	$85 - $122	96%
Wellpoint Mcaid - All Other Plans	$139	156%
Ia Total Care Comm - All Other Plans	$158	178%
Midlands Choice - All Plans	$318	358%

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 $100.
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 St Anthony Regional Hospital & Nursing Home 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.