X-ray, foot

For the X-ray of the foot (CPT 73630) at the University Of Kansas Health System - St Francis Campus in Topeka, KS, the facility's gross charge is $898.00, which is significantly higher than the Medicare benchmark of $88.91. While the facility's cash median price of $269.00 is lower than the gross charge, it remains above the Medicare rate, illustrating how commercial pricing can exceed the federal baseline. In this specific case, the cash price is also lower than the median negotiated rate of $442.00 paid by most insurers, meaning patients with high-deductible plans might save money by paying cash directly rather than using insurance, provided they qualify for the cash rate. It is important to note that many payers, including Blue Cross Blue Shield and Aetna, have negotiated rates ranging from $294 to $442, which are still substantially higher than the Medicare benchmark, highlighting the significant markup often found in commercial contracts.

Patients should be aware that while the facility is a voluntary non-profit church-owned acute care hospital, the negotiated rates vary widely depending on the payer, with some plans like Ks Disability Determination having rates as high as $1,077. To minimize costs, individuals should verify their specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest price can lead to overpayment. Additionally, asking the hospital about "self-pay" or "prompt-pay" discounts before check-in can result in substantial fee reductions, as these incentives bypass the administrative overhead and collection fees associated with insurance billing. If a balance bill arises from out-of-network ancillary