X-ray, foot
Facility: Clara Barton Hospital
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- 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 | $133 | 150% |
| 6 Degrees Health - All Plans | $171 - $256 | 192% |
| Wppa-All Plans | $195 - $292 | 219% |
| Aetna | $220 - $328 | 247% |
| Phcs - All Plans | $220 - $328 | 247% |
| UnitedHealthcare | $220 - $328 | 247% |
| Hlth Partners Of Ks-All Plans | $224 - $336 | 252% |
Consumer Guidance & Cost Commentary
For an X-ray of the foot at Clara Barton Hospital in Hoisington, KS, the cash price is $213.00, which is lower than the facility's negotiated rates for most major payers. While the hospital's negotiated rates range from $133 to $336 depending on the insurance plan, the cash price remains the most predictable cost for patients without insurance or those with high-deductible plans. It is important to note that commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%, meaning the negotiated rate may exceed the cash price even for in-network members. Patients should verify their specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest possible price can lead to unexpected costs if the insurer's negotiated rate is higher than the cash option.
The facility's pricing structure is benchmarked against Medicare, which sets a fixed reimbursement rate of $88.91 for this procedure. The hospital's cash price of $213.00 represents a markup of 2.5 times the Medicare amount, which aligns with the typical range where fair pricing is defined as 120% to 150% of Medicare, though commercial contracts often average 200% to 300%. To ensure you are receiving the best possible rate, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you pay in