X-ray, ankle
Facility: Wilson Medical Center
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $221
- Cash Discount Price: $207
- vs. Medicare Baseline: 2.49x 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 249% of the Medicare baseline (a markup of 149%). 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 - $276 | 155% |
| UnitedHealthcare | $146 - $257 | 164% |
| Tricare | $146 | 164% |
| Humana | $146 | 164% |
| Ambetter / Centene | $146 - $276 | 164% |
| Aetna | $146 - $276 | 164% |
| Cigna | $221 | 249% |
| Mulitplan-All Plans | $254 | 286% |
| Health Partners-All Plans | $254 | 286% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610) at Wilson Medical Center in Neodesha, KS, the facility's cash median price is $207.00, which is lower than the negotiated rates paid by most major insurers like Blue Cross Blue Shield, UnitedHealthcare, and Aetna, where allowed amounts range from $146 to $276. This pricing structure highlights a common billing dynamic where commercial insurance contracts often result in higher out-of-pocket costs for patients compared to self-pay options, particularly for those with high-deductible plans. Since the facility is a Critical Access Hospital with government ownership, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes bypass the administrative overhead and negotiated markups embedded in insurance contracts.
When evaluating the cost of this service, it is essential to compare rates against the Medicare benchmark rather than the facility's gross chargemaster list. The Medicare amount for this code is $88.91, and the facility's cash rate of $207.00 represents a markup relative to this federal baseline, which serves as the most objective measure of true cost. While the data does not provide specific county or state average comparisons for this exact procedure, patients should be aware that commercial negotiated rates frequently exceed fair pricing benchmarks defined as 120% to 150% of Medicare. To avoid unexpected balance billing or errors, consumers should request a full itemized bill before payment, ensuring all charges are clearly listed and disputing any unbundled codes or services not rendered.