X-ray, foot
Facility: Holton Community Hospital
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $344
- Cash Discount Price: $346
- vs. Medicare Baseline: 3.87x 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 387% of the Medicare baseline (a markup of 287%). 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 | $133 | 150% |
| Aetna | $202 - $541 | 227% |
| UnitedHealthcare | $202 - $541 | 227% |
| Humana | $204 - $290 | 229% |
| Kansas Superior Select - All Plans | $207 - $292 | 233% |
| Preferred Health Fn Select - All Other Plans | $317 - $449 | 357% |
| Preferred Health Professionals | $317 - $449 | 357% |
| Preferred Health Freedom | $317 - $449 | 357% |
| Wppa Providers - All Plans | $363 - $514 | 408% |
| Medicaid / KanCare | $382 - $541 | 430% |
Consumer Guidance & Cost Commentary
For the X-ray of the foot (CPT 73630) at Holton Community Hospital in Holton, Kansas, the cash price is $346.00, which is lower than the facility's gross charge of $462.00. This cash rate is notably higher than the state average for this procedure, suggesting that patients paying out-of-pocket may find this option more affordable than expected for their specific situation. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $202 to $541, these negotiated amounts often exceed the cash price. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $346.00 directly can sometimes result in lower total costs compared to the insurance negotiated rate, provided the patient understands their specific plan's coverage limits.
To ensure you receive the most accurate pricing, it is essential to request an itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If you choose to pay with insurance, be aware that the facility's negotiated rates vary significantly by payer, with Medicaid/KanCare rates ranging from $382 to $541 and Blue Cross Blue Shield rates fixed at $133. Additionally, ask the billing department about prompt-pay discounts, which can reduce the cash price by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing. Always verify your deductible status before scheduling, as paying the negotiated rate without meeting your deductible could lead to unexpected financial exposure, whereas paying the cash price outright avoids these complexities entirely.