X-ray, ankle
Facility: Clara Barton Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $224
- Cash Discount Price: $213
- vs. Medicare Baseline: 2.52x 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 252% of the Medicare baseline (a markup of 152%). 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% |
| 6 Degrees Health - All Plans | $171 - $256 | 192% |
| Wppa-All Plans | $195 - $292 | 219% |
| Phcs - All Plans | $220 - $328 | 247% |
| UnitedHealthcare | $220 - $328 | 247% |
| Aetna | $220 - $328 | 247% |
| Hlth Partners Of Ks-All Plans | $224 - $336 | 252% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610) at Clara Barton Hospital in Hoisington, KS, the facility's cash price of $213.00 is notably lower than the median negotiated rates paid by major insurers, which range from $171 to $336 depending on the plan. While the hospital's cash rate is higher than the national average of $213.00, it remains significantly below the gross chargemaster price of $305.00. Patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance allowed amount, as commercial negotiated rates often exceed the cash price due to administrative costs and contract structures. It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the lowest possible rate.
The facility's pricing is evaluated against the Medicare benchmark of $88.91, which serves as a scientifically validated baseline for the true cost of care. The commercial negotiated rates observed here are substantially higher than the Medicare rate, reflecting the standard markup found in the healthcare industry where commercial contracts often average 200% to 300% of Medicare amounts. If a patient receives an out-of-network balance bill, they should verify the legality of the charge under the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities. Furthermore, patients should request a full itemized bill to identify any errors, such as unbundled codes or services not rendered, as over 80