X-ray, ankle
Facility: Rooks County Health Center
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $211
- Cash Discount Price: $176
- vs. Medicare Baseline: 2.37x 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 237% of the Medicare baseline (a markup of 137%). 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 |
|---|---|---|
| Tricare | $110 | 124% |
| Veterans Admin - All Plans | $110 | 124% |
| Celtic Mcr Adv | $110 | 124% |
| Celtic Comm - All Other Plans | $121 | 136% |
| Blue Cross Blue Shield | $139 | 156% |
| Preferred Benefits Admin | $211 | 237% |
| Aetna | $211 | 237% |
| UnitedHealthcare | $211 | 237% |
| Preferred Hlthcare - All Other Plans | $223 | 251% |
| Health Partners - All Plans | $223 | 251% |
| Healthy Blue Mcaid - All Plans | $235 | 264% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610) at Rooks County Health Center in Plainville, KS, the facility's negotiated rates range from $110 to $235, with a median negotiated amount of $211. This median rate is significantly higher than the state average of $121, indicating that commercial insurance contracts at this Critical Access Hospital are priced above the typical state benchmark. While the facility offers a cash median price of $176, which is lower than the negotiated rates for most commercial payers, patients should be aware that commercial insurance often includes administrative overhead that inflates the baseline price by 20% to 40%. Consequently, for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $176 upfront may result in lower total costs compared to the $211 median allowed by insurers, provided the patient's plan does not cover the full amount.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $88.91 for this service. The facility's cash median of $176 represents a markup of 2.4 times the Medicare rate, while the median negotiated rate of $211 exceeds the Medicare benchmark by a factor of 2.4. This disparity highlights the importance of verifying in-network allowed amounts before scheduling, as commercial rates can vary widely even within the same network tier. To further reduce costs, patients should explicitly request "self-pay" or "prompt-pay" discounts prior to check-in, as hospitals often offer fee reductions of 20% to 50% for upfront payment