X-ray, ankle
Facility: Kiowa District Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $259
- Cash Discount Price: $219
- vs. Medicare Baseline: 2.91x 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 291% of the Medicare baseline (a markup of 191%). 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 |
|---|---|---|
| Tricare | $107 | 120% |
| Blue Cross Blue Shield | $138 | 155% |
| Healthchoice-All Plans | $160 | 180% |
| UnitedHealthcare | $219 - $274 | 246% |
| Health Partners Of Ks-All Plans | $241 | 271% |
| Humana | $247 | 278% |
| Gbs Insurance - All Plans | $258 | 290% |
| Multiplan-All Plans | $258 | 290% |
| Medicare (plans) | $260 | 292% |
| Aetna | $260 | 292% |
| Triwest-All Plans | $260 | 292% |
| Medicaid / KanCare | $274 | 308% |
| Providers Care (Wppa)-All Plans | $411 | 462% |
| Liberty Healthshare-All Plans | $443 | 498% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610) at Kiowa District Hospital in Kiowa, KS, the facility's cash price of $219.00 is lower than the state average of $258.00, making it a cost-effective option for self-pay patients. While the hospital's negotiated rates with insurance carriers range from $107 for Tricare up to $443 for Liberty Healthshare, these amounts often exceed the cash price, which can be beneficial for patients with high-deductible plans who may not yet have met their out-of-pocket limits. It is important to note that while the facility is a Critical Access Hospital owned by a Government Hospital District, patients should verify their specific plan's allowed amount before scheduling, as some in-network rates can be significantly higher than the cash rate. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, as paying the bill in full upfront can sometimes result in further fee reductions beyond the base cash price.
The Medicare benchmark for this service is $88.91, which serves as a critical baseline for evaluating the facility's pricing markup. The facility's cash rate of $219.00 represents a significant increase over the Medicare amount, reflecting the costs of local wages and facility operations in the 67070 zip code. Commercial negotiated rates, which average between 200% and 300% of Medicare, are common in this sector, though the facility's specific contracts with payers like UnitedHealthcare and Medicaid/KanCare show a wider variance. Consumers should be aware that balance billing is generally prohibited for emergency care under the No Sur