X-ray, ankle
Facility: Hiawatha Community Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $592
- Cash Discount Price: $760
- vs. Medicare Baseline: 6.66x 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 666% of the Medicare baseline (a markup of 566%). 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 | $132 - $139 | 148% |
| UnitedHealthcare | $281 - $653 | 316% |
| Aetna | $281 - $614 | 316% |
| Humana | $284 | 319% |
| Ambetter / Centene | $337 | 379% |
| Oscar - All Plans | $570 | 641% |
| Centrus Health Direct - All Plans | $570 | 641% |
| Preferred Hlth - All Plans | $684 | 769% |
| Wppa Providrs Care - All Plans | $722 | 812% |
| Cigna | $722 | 812% |
| Multiplan - All Plans | $737 | 829% |
| Midlands Choice - All Plans | $737 | 829% |
| Healthy Blue Mcaid - All Plans | $760 | 855% |
Consumer Guidance & Cost Commentary
For this X-ray of the ankle at Hiawatha Community Hospital, the cash price is $760, which matches the facility's gross charge and the median paid by some payers. While the facility is a Critical Access Hospital in Hiawatha, KS, the data does not provide specific county or state average figures for comparison. However, the Medicare benchmark for this procedure is $88.91, highlighting that the cash rate is significantly higher than the federal baseline. Patients with high-deductible plans may find paying the full cash price upfront more cost-effective than using insurance, as the negotiated rates for in-network plans range from $132 to $760, with many plans settling at amounts exceeding the cash price.
To minimize costs, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the bill by 20% to 50% if paid in full within a short window. It is important to avoid balance billing, which occurs when a provider bills the difference between their full charge and the insurance allowed amount; under the No Surprises Act, such billing is generally prohibited for emergency care and non-emergency services at in-network facilities. If a patient receives an itemized bill, they should request a detailed breakdown to verify that no unbundled codes or services not rendered have been charged, ensuring the final amount aligns with the negotiated or cash rates discussed.