X-ray, foot
Facility: F W Huston Medical Center
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $280
- Cash Discount Price: $291
- vs. Medicare Baseline: 3.15x 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 315% of the Medicare baseline (a markup of 215%). 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 | $135 | 152% |
| Aetna | $273 | 307% |
| Humana | $288 | 324% |
| Cigna | $309 | 348% |
Consumer Guidance & Cost Commentary
For this X-ray of the foot at F W Huston Medical Center in Winchester, KS, the facility's cash price of $291 is lower than the gross charge of $364, offering a potential savings for patients with high-deductible plans who may not need insurance coverage. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates paid by major payers like Blue Cross Blue Shield ($135), Aetna ($273), and Humana ($288) are significantly higher than the cash price. This price difference highlights how administrative costs and insurance claim processing can inflate the final bill for insured patients, making it worth checking with the hospital for "self-pay" or "prompt-pay" discounts before scheduling to ensure you are not paying the full negotiated rate.
The Medicare benchmark for this service is $88.91, which serves as a critical baseline for evaluating the facility's pricing markup. Although the data does not provide specific county or state average comparisons for this code, the facility's gross charge of $364 represents a substantial increase over the Medicare rate, illustrating the common practice of charging higher list prices to commercial insurers. Patients 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 you should not pay surprise bills immediately without disputing them with your insurer. Additionally, if you receive a summary bill, you should request a full itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.