X-ray, ankle
Facility: Medicine Lodge Memorial Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $240
- Cash Discount Price: $253
- vs. Medicare Baseline: 2.70x 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 270% of the Medicare baseline (a markup of 170%). 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 | $202 | 227% |
| Humana | $230 | 259% |
| Aetna | $234 - $253 | 263% |
| Hpk-All Plans | $240 | 270% |
| UnitedHealthcare | $240 | 270% |
| Medicaid / KanCare | $253 | 285% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610) at Medicine Lodge Memorial Hospital in Medicine Lodge, Kansas, the cash price is $253.00, which matches the facility's negotiated rate for Medicaid/KanCare and the gross charge. This cash price is significantly higher than the Medicare benchmark of $88.91, reflecting a markup of 2.7 times the federal rate. While commercial payers like Aetna and UnitedHealthcare have negotiated rates ranging from $234 to $253, these amounts remain well above the Medicare baseline. Patients with high-deductible plans may find it financially advantageous to pay the cash price of $253.00 directly, as this could be lower than their insurance's negotiated allowed amount if they have not yet met their deductible, thereby avoiding out-of-pocket costs that exceed the cash rate.
To ensure you are receiving the most accurate pricing, it is important to request an itemized bill before finalizing payment, as summary bills often obscure individual charges and potential errors. If you choose to pay out-of-pocket, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled within 30 days. Since this facility is a Critical Access Hospital owned by a Government Hospital District, verify that your specific plan is in-network to avoid balance billing, though the No Surprises Act protects you from unexpected bills for emergency services at in-network facilities. Always compare the facility's rates against state averages and confirm your deductible status before scheduling to ensure you are not paying more than necessary.