X-ray, ankle
Facility: Nmc Health
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $137
- Cash Discount Price: $213
- vs. Medicare Baseline: 1.54x 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 |
|---|---|---|
| Bluestem Pace | $8 - $84 | 9% |
| Medicaid / KanCare | $12 - $134 | 13% |
| Leading Age | $12 - $134 | 13% |
| Wppa | $15 - $329 | 17% |
| Occunet | $17 - $359 | 19% |
| Samaritan Ministries International | $18 - $389 | 20% |
| Medincrease Health Plan | $18 - $389 | 20% |
| Prime Health Services | $21 - $449 | 24% |
| Aetna | $23 - $46 | 26% |
| UnitedHealthcare | $25 - $539 | 28% |
| Cigna | $27 - $569 | 30% |
| Blue Cross Blue Shield | $139 | 156% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610) at Nmc Health in Newton, KS, the facility's cash price of $213.00 is significantly higher than the state average, which sits at $137.00. While commercial insurance plans like Blue Cross Blue Shield and UnitedHealthcare negotiate rates that can reach up to $569 and $539 respectively, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated rate could be substantially higher. To potentially lower costs, it is recommended to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%.
When evaluating the cost of this service, it is important to compare the facility's pricing against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this code is $88.91, and the facility's cash price represents a markup of 1.5 times the Medicare rate. Although the facility is a voluntary non-profit with a high rating, the negotiated rates for major payers like Cigna and Prime Health Services can still result in higher out-of-pocket costs compared to paying cash. Consumers should request an itemized billing audit to ensure no errors exist, as over 80% of hospital bills contain mistakes that could be corrected. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at this in-network acute care hospital, so unexpected bills for emergency or mandatory ancillary services should not