X-ray, ankle
Facility: Holton Community Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $387
- Cash Discount Price: $364
- vs. Medicare Baseline: 4.35x 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 435% of the Medicare baseline (a markup of 335%). 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 | $138 | 155% |
| Aetna | $228 - $541 | 256% |
| UnitedHealthcare | $228 - $541 | 256% |
| Humana | $230 - $290 | 259% |
| Kansas Superior Select - All Plans | $232 - $292 | 261% |
| Preferred Health Freedom | $357 - $449 | 402% |
| Preferred Health Professionals | $357 - $449 | 402% |
| Preferred Health Fn Select - All Other Plans | $357 - $449 | 402% |
| Wppa Providers - All Plans | $408 - $514 | 459% |
| Medicaid / KanCare | $430 - $541 | 484% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610) at Holton Community Hospital in Holton, KS, the facility's cash price of $364.00 is significantly lower than the negotiated rates charged to most insurance plans, which range from $228 to $541 depending on the carrier. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and network tiering. For individuals with high-deductible plans, paying the cash price directly may be more cost-effective than relying on insurance, as the negotiated rates frequently exceed the cash median. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final amount owed by bypassing the costly insurance claims processing cycle.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this code is $88.91, which serves as a scientifically validated baseline for the true cost of care, whereas commercial rates often average 200% to 300% of this figure. Although the data provided does not include specific state or county average comparisons for this procedure, the Medicare rate highlights that the facility's cash price of $364.00 represents a substantial markup over the federal baseline. To avoid unexpected balance billing or errors, patients should request a full itemized bill before paying, ensuring that all charges are accurate and that no unbundled codes or services not rendered are included in the final