CMS Price Transparency Data

X-ray, foot

Facility: Nemaha Valley Community Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $137
  • Cash Discount Price: $241
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Nemaha Valley Community Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.54x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$241

Average discount available for prompt cash payment at this facility.

Insurance Median
$137

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: $241 (271%)
Insurance Median: $137 (154%)
Cash: $241 (271% of Medicare)
Ins. Median: $137 (154% 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 $118 133%
Va Ccn - All Plans $118 133%
Aetna $119 - $228 134%
Celtic Comm Exch - All Plans $130 146%
Blue Cross Blue Shield $135 152%
Partners Direct Health - All Plans $139 156%
Multiplan - All Plans $241 271%
Midlands Choice - All Plans $255 287%
Health Partners - All Plans $255 287%

Consumer Guidance & Cost Commentary

For the X-ray of the foot (CPT 73630) at Nemaha Valley Community Hospital in Seneca, Kansas, the facility's cash median price is $241.00, which is notably higher than the state average of $139.00. While commercial insurance plans like Aetna and Multiplan have negotiated rates ranging from $118 to $255, these amounts often exceed the cash price for patients with high-deductible plans. Because insurance billing involves administrative overhead that can inflate rates by 20% to 40%, paying cash upfront may result in a lower total cost. Patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full within 30 days, effectively bypassing the costly claims processing cycle.

The facility's negotiated rates for this service vary significantly by payer, with the lowest allowed amount being $118 and the highest at $255, reflecting the complex dynamics of network tiering and contract management. It is important to note that being in-network does not guarantee the lowest possible price, as different insurers negotiate different ceilings that may not align with the facility's cash pricing. To ensure you are not overpaying, always request an itemized bill before finalizing payment to check for errors or unbundled codes, as over 80% of hospital bills contain inaccuracies. Furthermore, comparing the facility's rates to the Medicare benchmark of $88.91 reveals that commercial rates often represent a substantial markup, so consumers should focus on the actual negotiated or cash amounts rather than the hospital's

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