X-ray, foot
Facility: Stormont Vail Hospital
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- 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 |
|---|---|---|
| Ambetter / Centene | $50 - $75 | 56% |
| Blue Cross Blue Shield | $50 - $263 | 56% |
| UnitedHealthcare | $50 - $75 | 56% |
| Aetna | $79 - $81 | 89% |
| Humana | $79 - $81 | 89% |
Consumer Guidance & Cost Commentary
For the CPT code 73630 (X-ray, foot) at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates range from $50 to $263 depending on the insurance plan, with a median negotiated payment of $79.00. This rate is significantly lower than the facility's gross charge of $367.00, reflecting standard contractual caps. However, the negotiated rate of $79.00 is higher than the facility's cash median, which is not listed in this report. Patients with high-deductible plans or those without insurance should consider paying cash directly, as this can sometimes result in a lower out-of-pocket cost than what their insurance would allow. It is important to verify if the hospital offers a "self-pay" or "prompt-pay" discount for upfront payment, as these incentives can bypass the administrative overhead embedded in commercial negotiated rates.
The Medicare benchmark for this service is $88.91, which serves as a reliable baseline for evaluating pricing fairness. The facility's median negotiated rate of $79.00 is slightly below the Medicare amount (a ratio of 0.9), indicating that the commercial rate is competitive relative to the federal government's cost-based reimbursement. While the gross charge is substantially higher, patients should avoid using the chargemaster list as a benchmark for savings, as it inflates the perceived discount. If a patient receives a bill that exceeds the allowed amount, they should request an itemized billing audit to identify errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies. Furthermore, under the No Surprises Act,