CMS Price Transparency Data

X-ray, foot

Facility: Pinckneyville Community Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $146
Cash Discount Price: $234
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Pinckneyville Community Hospital is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.64x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.

Cash / Self-Pay

$234

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $234 (263%)

Insurance Median: $146 (164%)

Cash: $234 (263% of Medicare)

Ins. Median: $146 (164% 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	$8 - $349	9%
Humana	$8 - $144	9%
Umwa Mcr Adv - All Plans	$8 - $144	9%
UnitedHealthcare	$8 - $318	9%
Wellcare Mcr Adv - All Plans	$8 - $144	9%
Cigna	$10 - $320	11%
Blue Cross Blue Shield	$17 - $312	19%
Healthlink Hmo	$50 - $305	56%
Healthlink Ppo - All Other Plans	$50 - $320	56%
Phcs Savility	$68 - $330	76%
Multiplan - All Plans	$72 - $349	81%
Phcs - All Other Plans	$72 - $318	81%
Ambetter / Centene	$307 - $312	345%
Medicaid / KanCare	$307 - $312	345%
Healthlink Work Comp	$320	360%

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 $234.
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 Pinckneyville Community 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.