X-ray, ankle
Facility: Stormont Vail Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $79
- Cash Discount Price: Unavailable
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $50 - $263 | 56% |
| Ambetter / Centene | $50 - $75 | 56% |
| UnitedHealthcare | $50 - $75 | 56% |
| Aetna | $79 - $81 | 89% |
| Humana | $79 - $81 | 89% |
Consumer Guidance & Cost Commentary
For the CPT code 73610 (X-ray, ankle) at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $50 to $81, while the median amount paid across all plans is $81.00. This negotiated rate is 90% of the Medicare benchmark of $88.91, indicating the facility is pricing at a level consistent with fair market value rather than applying a significant markup. It is important to note that while insurance contracts cap charges for members, these negotiated rates often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash price directly, provided they verify the facility's specific self-pay or prompt-pay discounts before scheduling.
Patients should be aware that commercial insurance rates are frequently inflated by administrative costs and contract dynamics, sometimes reaching 200% to 300% of the Medicare baseline, whereas fair pricing is typically defined as 120% to 150% of Medicare. In this instance, the facility's rates align closely with the Medicare standard, offering transparency compared to the potential for higher markups seen elsewhere. To ensure you are not overcharged, always request a full itemized bill before paying, as summary invoices can obscure individual line items and errors. If you receive a balance bill for out-of-network services at this in-network facility, you may have protections under the No Surprises Act, and you should dispute any unexpected charges in writing rather than accepting summary totals or verbal assurances.