X-ray, foot
Facility: Hiawatha Community Hospital
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $367
- Cash Discount Price: $471
- vs. Medicare Baseline: 4.13x 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 413% of the Medicare baseline (a markup of 313%). 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 | $128 - $135 | 144% |
| Aetna | $174 - $381 | 196% |
| UnitedHealthcare | $174 - $405 | 196% |
| Humana | $176 | 198% |
| Ambetter / Centene | $209 | 235% |
| Oscar - All Plans | $353 | 397% |
| Centrus Health Direct - All Plans | $353 | 397% |
| Preferred Hlth - All Plans | $424 | 477% |
| Cigna | $447 | 503% |
| Wppa Providrs Care - All Plans | $447 | 503% |
| Midlands Choice - All Plans | $457 | 514% |
| Multiplan - All Plans | $457 | 514% |
| Healthy Blue Mcaid - All Plans | $471 | 530% |
Consumer Guidance & Cost Commentary
For the X-ray of the foot (CPT 73630) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $471.00, which matches the facility's gross charge and the median cash rate. This cash price is significantly higher than the state average for this service, as indicated by the 4.1x multiplier relative to the Medicare benchmark of $88.91. While commercial insurance plans like Blue Cross Blue Shield and Aetna negotiate rates ranging from $128 to $405, these negotiated amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the full cash price of $471.00 upfront can be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the patient's deductible has not yet been met.
Patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce the total bill by 20% to 50% for upfront payments. It is also important to request an itemized billing audit before finalizing payment, as summary bills may obscure errors or unbundled charges that should be consolidated. Since this facility is a Critical Access Hospital with a voluntary non-profit ownership structure, comparing the negotiated rates across the 13 participating payers reveals a wide variance, with rates as low as $128 and as high as $471. To ensure you are receiving the best possible rate, always confirm your specific plan's allowed amount and ask the billing department to classify your account as self-pay prior to scheduling your appointment.