X-ray, ankle
Facility: Ellsworth County Medical Center
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $158
- Cash Discount Price: $175
- vs. Medicare Baseline: 1.78x 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.
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 |
|---|---|---|
| Humana | $82 - $166 | 92% |
| Triwest -All Plans | $82 | 92% |
| Va Ccn-All Plans | $82 | 92% |
| Healthy Blue Mcr Adv | $82 | 92% |
| UnitedHealthcare | $114 - $175 | 128% |
| Blue Cross Blue Shield | $131 - $138 | 147% |
| Aetna | $158 | 178% |
| First Health - All Plans | $158 | 178% |
| Cigna | $166 | 187% |
| Coventry Mcaid-All Plans | $175 | 197% |
| Healthy Blue Mcaid- All Other Plans | $175 | 197% |
| Medicaid / KanCare | $175 | 197% |
| Providers Care-Wppa-All Plans | $262 | 295% |
Consumer Guidance & Cost Commentary
For this X-ray of the ankle at Ellsworth County Medical Center in Ellsworth, KS, the facility's cash price is $175.00, which matches the highest negotiated rates charged to certain payers like Coventry and Medicaid. While the median amount paid by insurance across all plans was $136.00, the cash price is notably higher than the facility's negotiated average of $158.00. Patients with high-deductible plans should consider paying cash directly, as the cash rate may be lower than their specific insurance allowed amount, effectively reducing their out-of-pocket cost. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary significantly by carrier and can sometimes exceed the cash-pay option.
The facility, a Critical Access Hospital, bills at a rate 1.8 times the Medicare benchmark of $88.91, which serves as the objective baseline for fair pricing. Although the facility's rating is 2, the pricing structure suggests that commercial negotiated rates include administrative overhead that can inflate the baseline price. To minimize costs, patients should request a prompt-pay discount if paying upfront, which typically bypasses costly claims processing and administrative fees. Additionally, if you receive a bill after an insurance claim, ensure it is an itemized statement rather than a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed in writing to reduce medical debt.