CMS Price Transparency Data

X-ray, ankle

Facility: Valley West Community Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $504
Cash Discount Price: $542
vs. Medicare Baseline: 5.67x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Valley West Community Hospital is $504. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $542. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.67x the Medicare baseline. Located in 11 East Pleasant Avenue, Sandwich, IL.

Cash / Self-Pay

$542

Average discount available for prompt cash payment at this facility.

Insurance Median

$504

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: $542 (610%)

Insurance Median: $504 (567%)

Cash: $542 (610% of Medicare)

Ins. Median: $504 (567% 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 567% of the Medicare baseline (a markup of 467%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$147 - $632	165%
Global Excel [1712]	$147	165%
Humana	$147	165%
Aetna	$197 - $536	222%
Health'S Finest Network [126]	$348 - $658	391%
The Alliance [1703]	$421	474%
Choicecare [177]	$522	587%
Healthlink [125]	$580	652%
Multiplan/Phcs [142]	$619 - $774	696%
First Health Plan [6034]	$774	871%
UnitedHealthcare	$774	871%

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 $542.
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 Valley West Community 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.