CMS Price Transparency Data

X-ray, ankle

Facility: Nemaha Valley Community Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $138
  • Cash Discount Price: $237
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Nemaha Valley Community Hospital is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.55x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$237

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $237 (267%)
Insurance Median: $138 (155%)
Cash: $237 (267% of Medicare)
Ins. Median: $138 (155% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Humana $116 130%
Va Ccn - All Plans $116 130%
Aetna $117 - $224 132%
Celtic Comm Exch - All Plans $127 143%
Partners Direct Health - All Plans $137 154%
Blue Cross Blue Shield $139 156%
Multiplan - All Plans $237 267%
Health Partners - All Plans $250 281%
Midlands Choice - All Plans $250 281%

Consumer Guidance & Cost Commentary

For the X-ray, ankle procedure (CPT 73610) at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash price of $237.00 is notably higher than the state average, which sits at $138.00. While commercial insurance negotiated rates range from $116 to $250 depending on the plan, patients should be aware that cash payments can sometimes be more cost-effective if their insurance negotiated rate exceeds the cash price. This facility, a Critical Access Hospital, operates under a voluntary non-profit structure, and while the gross charge is $263.00, the actual amount paid by insurers varies significantly based on the specific plan.

To minimize out-of-pocket costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. It is also important to understand that Medicare rates for this service are $88.91, serving as a benchmark for fair pricing; commercial rates often exceed this baseline due to administrative overhead and contract dynamics. If you receive a bill, request a full itemized statement to verify that all charges are accurate and that no services were bundled incorrectly, as over 80% of hospital bills contain errors that can be corrected through a formal audit.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Community Dr, Seneca, KS 66538
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals