CMS Price Transparency Data

X-ray, foot

Facility: Norton-King's Daughters' Health

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $352
Cash Discount Price: $90
vs. Medicare Baseline: 3.96x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Norton-King's Daughters' Health is $352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.96x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$352

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: $90 (101%)

Insurance Median: $352 (396%)

Cash: $90 (101% of Medicare)

Ins. Median: $352 (396% 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 396% of the Medicare baseline (a markup of 296%). 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
Aetna	$7 - $369	8%
Blue Cross Blue Shield	$16 - $309	18%
Managed Health Services Of Indiana	$16	18%
UnitedHealthcare	$16 - $329	18%
Humana	$92	103%
Managed Health Services	$95 - $143	107%
Caresource Of Kentucky	$129	145%
Caresource Of Indiana	$138	155%
Custom Design Benefits	$184 - $210	207%
Cigna	$336 - $356	378%
Encore	$336 - $356	378%
Quality Care Partners	$352 - $373	396%
Bluegrass	$356 - $377	400%
First Health	$356 - $377	400%
Healthlink	$356 - $377	400%
Vha/Tristate	$356 - $377	400%
Multiplan/Phcs	$363 - $385	408%
Indiana Health Network	$375 - $398	422%
Siho	$375 - $398	422%

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 $90.
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 Norton-King's Daughters' Health 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.