X-ray, ankle
Facility: Ashland Health Center
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $194
- Cash Discount Price: $155
- vs. Medicare Baseline: 2.18x 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 218% of the Medicare baseline (a markup of 118%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $65 | 73% |
| Compalliance-All Plans | $155 | 174% |
| Health Partners Of Kansas-All Plans | $165 | 186% |
| Multiplan-All Plans | $190 | 214% |
| Healthy Blue Mcr Adv - All Other Plans | $194 | 218% |
| Medicare (plans) | $194 | 218% |
| Health Choice-All Plans | $194 | 218% |
| Medica Mcare - All Plans | $194 | 218% |
| Aetna | $194 | 218% |
| Medicaid / KanCare | $194 | 218% |
| UnitedHealthcare | $194 | 218% |
| Providers Care (Wppa)-All Plans | $291 | 327% |
Consumer Guidance & Cost Commentary
For the CPT code 73610 (X-ray, ankle), Ashland Health Center in Ashland, KS, has a gross charge of $194.00. While the facility's cash median rate is $155.00, the negotiated rates for most major payers, including Medicare, Medicaid/KanCare, and UnitedHealthcare, are set at $194.00. This indicates that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $155.00 could result in significant savings compared to the insurance negotiated rate. However, patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
It is important to understand that the $194.00 negotiated rate represents the contractual ceiling for in-network coverage, not necessarily the lowest possible price. Since the cash rate is lower than the negotiated amount, patients with commercial insurance should consider paying out-of-pocket if their deductible has not been met. Additionally, because this is a Critical Access Hospital, the facility's pricing is benchmarked against federal standards; the Medicare amount of $88.91 serves as the objective baseline for cost, showing that the commercial negotiated rate includes administrative overhead and profit margins typical of the healthcare system. Consumers are encouraged to request an itemized bill to ensure no unbundled charges or errors exist before finalizing payment.