CMS Price Transparency Data

X-ray, ankle

Facility: Woodlawn Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $152
Cash Discount Price: $418
vs. Medicare Baseline: 1.71x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Woodlawn Hospital is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $418. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.71x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$418

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $418 (470%)

Insurance Median: $152 (171%)

Cash: $418 (470% of Medicare)

Ins. Median: $152 (171% 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
Blue Cross Blue Shield	$18 - $536	20%
Caresource Mcaid Hww	$18	20%
Mdwise Excel Hhw & Hcc	$18	20%
Mhs Mcaid Hcc	$18	20%
Mhs Mcaid Hhw	$18	20%
UnitedHealthcare	$18 - $508	20%
Aetna	$98 - $636	110%
Caresource Mcaid Hip	$98 - $147	110%
Caresource Mcr Adv	$98 - $147	110%
Humana	$98 - $519	110%
Mdwise Mcaid Excel Hip	$98 - $147	110%
Mhs Exch Mrktplce-All Other Plans	$98 - $147	110%
Mhs Mcaid Hip	$98 - $147	110%
Mhs Mcr Adv	$100 - $150	112%
Caresource Exch - All Other Plans	$128 - $191	144%
Ambetter / Centene	$130 - $196	146%
Partners Direct Health-All Plans	$303 - $455	341%
Cigna	$319 - $569	359%
Parkview Health Plans-All Plans	$334 - $502	376%
Sagamore All Other Grps - All Other Plans	$375 - $562	422%
Encore Comm-All Plans	$379 - $569	426%
Phcs/Multiplan-All Plans	$415 - $622	467%
Community Health Alliance-All Plans	$424 - $636	477%

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 $418.
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 Woodlawn 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.