X-ray, foot
Facility: Sheridan County Hospital
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $186
- Cash Discount Price: $250
- vs. Medicare Baseline: 2.09x 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 209% of the Medicare baseline (a markup of 109%). 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 |
|---|---|---|
| Celtic Insurance | $151 | 170% |
| Blue Cross Blue Shield | $186 | 209% |
| UnitedHealthcare | $238 | 268% |
Consumer Guidance & Cost Commentary
For the X-ray, foot procedure (CPT 73630) at Sheridan County Hospital in Hoxie, KS, the cash price is $250.00, which matches the facility's median negotiated rate of $186.00 for in-network payers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare. While the facility is a Critical Access Hospital with government local ownership, the cash price is notably higher than the state of Kansas average, which is approximately 2.1 times the Medicare benchmark of $88.91. Patients with high-deductible plans or those without insurance may find the cash price more favorable than the insurance negotiated rate, as paying upfront can sometimes bypass administrative fees and claim processing costs that inflate the final bill. It is important to verify if the hospital offers a "prompt-pay" discount for immediate payment, which could further reduce the cost, and to explicitly request a self-pay classification before scheduling to avoid automatic claims submission that might void potential cash savings.
The Medicare benchmark for this service is $88.91, serving as a scientifically validated baseline for the true cost of care, whereas commercial rates often include significant markups for administrative overhead. Although the facility's cash price exceeds the Medicare rate, it is crucial to understand that the negotiated rates paid by insurers ($151 to $238 depending on the plan) are contractually capped and may not reflect the lowest possible price available. To ensure you are not overpaying, you should request a full itemized billing audit before paying any balance bill, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If