X-ray, foot
Facility: Cloud County Health Center
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $559
- Cash Discount Price: $412
- vs. Medicare Baseline: 6.29x 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 629% of the Medicare baseline (a markup of 529%). 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 |
|---|---|---|
| Aetna | $530 - $547 | 596% |
| Pponext-All Plans | $559 | 629% |
| Mpi-All Plans | $559 | 629% |
| Health Partners - All Plans | $559 | 629% |
Consumer Guidance & Cost Commentary
For the X-ray of the foot (CPT 73630) at Cloud County Health Center in Concordia, KS, the facility's cash median price is $412.00, which is lower than the state average of $559.00. While the facility's negotiated rates with major payers like Aetna, Pponext, MPI, and Health Partners average $559.00, this amount exceeds the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that the facility is a Voluntary non-profit Critical Access Hospital, and patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to ensure they are not billed the full negotiated amount.
The Medicare benchmark for this service is $88.91, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $412.00 represents a significant markup over the Medicare rate, reflecting the administrative costs and provider fees included in commercial billing structures. Since the facility is located in a Critical Access Hospital setting, patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still crucial to request an itemized bill to review every charge and avoid unexpected costs.