X-ray, ankle
Facility: Pratt Regional Medical Center
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $79
- Cash Discount Price: $59
- vs. Medicare Baseline: 0.89x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christian Health Aid | $21 - $290 | 24% |
| UnitedHealthcare | $23 - $395 | 26% |
| Health Partners Of Kansas | $24 - $329 | 27% |
| Aetna | $25 - $348 | 28% |
| Choicecare | $28 - $387 | 31% |
| Celtic Insurance Company | $84 | 94% |
| Healthy Blue | $87 | 98% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610) at Pratt Regional Medical Center, the cash price of $59.00 is lower than the facility's negotiated rates with major payers like UnitedHealthcare and Aetna, which range from $23 to $395. While the facility's cash price is slightly below the state of Kansas average, it is significantly lower than the Medicare benchmark of $88.91. For patients with high-deductible plans, paying the cash price upfront may result in lower out-of-pocket costs compared to insurance claims, provided the patient's deductible has not yet been met. It is important to note that the cash price does not include any potential prompt-pay discounts, which hospitals often offer for upfront payment to avoid administrative processing costs.
Patients should verify their specific insurance coverage and ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these rates can reduce the final bill by 20% to 50%. Although the facility is in-network for most major carriers, the wide variance in negotiated rates across different plans suggests that individual coverage details significantly impact the final cost. If a patient receives a bill that exceeds the allowed amount, they may be subject to balance billing for the difference between the provider's charge and the insurance payment, though the No Surprises Act protects against such billing for emergency services and non-emergency care from out-of-network providers at in-network facilities.