X-ray, foot
Facility: Rooks County Health Center
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- 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 |
|---|---|---|
| Veterans Admin - All Plans | $110 | 124% |
| Tricare | $110 | 124% |
| Celtic Mcr Adv | $110 | 124% |
| Celtic Comm - All Other Plans | $121 | 136% |
| Blue Cross Blue Shield | $135 | 152% |
| Aetna | $211 | 237% |
| UnitedHealthcare | $211 | 237% |
| Preferred Benefits Admin | $211 | 237% |
| Health Partners - All Plans | $223 | 251% |
| Preferred Hlthcare - All Other Plans | $223 | 251% |
| Healthy Blue Mcaid - All Plans | $235 | 264% |
Consumer Guidance & Cost Commentary
For the X-ray, foot procedure (CPT 73630) at Rooks County Health Center in Plainville, KS, the facility's negotiated rates range from $110 to $235, with a median paid amount of $211. This median negotiated rate aligns exactly with the median negotiated rate of $211 found across the state of Kansas, indicating that the facility's pricing is consistent with regional commercial insurance standards. However, the cash median price of $176 is lower than the negotiated rates, suggesting that patients with high-deductible plans or those without insurance may save money by paying out-of-pocket, as the cash price is below the amount commercial payers typically agree to reimburse.
The facility's gross charge of $235 is significantly higher than the Medicare benchmark of $88.91, reflecting a markup common in commercial healthcare settings where administrative costs and network negotiations drive prices well above the federal baseline. While the facility is a Critical Access Hospital owned by a Government Hospital District, there is no specific facility rating provided in the current data. Consumers should be aware that prompt-pay discounts, which can reduce bills by 20% to 50%, are often available for upfront payments and should be requested before check-in to avoid automatic claims submission that would void these savings. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status and request an itemized bill to ensure no unexpected charges are applied.