X-ray, ankle
Facility: Lane County Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $210
- Cash Discount Price: $210
- vs. Medicare Baseline: 2.36x 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 236% of the Medicare baseline (a markup of 136%). 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 |
|---|---|---|
| UnitedHealthcare | $189 - $210 | 213% |
| Aetna | $189 - $200 | 213% |
| Medicaid / KanCare | $210 - $231 | 236% |
| Healthy Blue Mcr Adv - All Other Plans | $210 | 236% |
| Healthy Blue Mcaid | $210 | 236% |
| Wppa Providers-All Plans | $315 | 354% |
Consumer Guidance & Cost Commentary
For the CPT code 73610 (X-ray, ankle) at Lane County Hospital in Dighton, KS, the cash price is $210.00, which matches the facility's median negotiated rate and the median amount paid by insurers. This code is billed at a 2.4x markup relative to the Medicare rate of $88.91. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find paying the full cash price of $210.00 more cost-effective than using insurance, as commercial negotiated rates often exceed the cash price due to administrative overhead. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can significantly reduce the final bill.
The data provided does not include specific state or county average pricing for this procedure, so a direct comparison to regional benchmarks cannot be made based on this report. However, the facility's pricing structure aligns with the principle that commercial rates frequently exceed Medicare benchmarks; in this case, the allowed amount is 2.4 times the federal rate. Consumers should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, meaning patients should not expect to be billed for the difference between the chargemaster and the insurance allowed amount for standard services. If a large bill arrives, patients should request a full itemized audit to verify that no unbundled codes or services not rendered have been charged, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.