X-ray, foot
Facility: Nmc Health
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $228
- Cash Discount Price: $315
- vs. Medicare Baseline: 2.56x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 256% of the Medicare baseline (a markup of 156%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Aetna | $45 | 51% |
| Bluestem Pace | $84 | 94% |
| Leading Age | $134 | 151% |
| Medicaid / KanCare | $134 | 151% |
| Blue Cross Blue Shield | $135 | 152% |
| Wppa | $167 - $327 | 188% |
| Occunet | $182 - $357 | 205% |
| Medincrease Health Plan | $198 - $387 | 223% |
| Samaritan Ministries International | $198 - $387 | 223% |
| Prime Health Services | $228 - $446 | 256% |
| UnitedHealthcare | $274 - $536 | 308% |
| Cigna | $289 - $565 | 325% |
Consumer Guidance & Cost Commentary
For this X-ray of the foot at Nmc Health in Newton, Kansas, the cash price is $315, which is lower than the facility's gross charge of $450. While the facility's negotiated rates with major payers like UnitedHealthcare and Cigna range from $274 to $565, the cash rate remains the most predictable option for patients without insurance. It is important to note that for individuals with high-deductible plans, paying the cash price of $315 upfront may be more cost-effective than relying on insurance, as the negotiated rates for many commercial plans exceed the cash amount. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
The facility's pricing is significantly higher than the state average, with the cash rate of $315 being 2.6 times the Medicare benchmark of $88.91. This markup reflects the administrative costs and contract structures inherent in commercial billing, where rates often average 200% to 300% of Medicare. If you have insurance, the allowed amount varies widely by carrier, with some plans like Wppa and Occunet having negotiated ranges starting at $167 and $182 respectively, while others like Aetna and Bluestem Pace have fixed negotiated rates of $45 and $84. To ensure you are not overcharged, request a detailed itemized bill that lists every specific CPT code and charge, as summary bills often obscure unbundled services or tests that were never rendered.