X-ray, ankle
Facility: Phillips County Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $245
- Cash Discount Price: $231
- vs. Medicare Baseline: 2.76x 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 276% of the Medicare baseline (a markup of 176%). 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 | $139 - $220 | 156% |
| UnitedHealthcare | $217 - $271 | 244% |
| Health Partners-All Plans | $271 | 305% |
| Medicaid / KanCare | $271 | 305% |
Consumer Guidance & Cost Commentary
For this X-ray of the ankle at Phillips County Hospital, the facility's cash price of $231.00 is notably lower than the typical negotiated rates paid by insurance companies, which range from $217 to $271 depending on the plan. While the cash rate is also lower than the facility's gross charge of $271.00, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients due to administrative fees and network tiering. In this specific case, the cash price is $40.00 less than the median negotiated rate of $245.00, meaning patients with high-deductible plans or those without insurance could save money by paying directly at the time of service. However, because the facility is a Critical Access Hospital in Phillips County, KS, and the cash rate is still above the Medicare benchmark of $88.91, patients should verify if their specific insurance plan allows for a lower allowed amount that might bridge the gap between the cash price and their deductible.
To ensure you are receiving the most accurate billing information, it is recommended to request an itemized bill before finalizing payment, as summary invoices can obscure individual charges and potential errors. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, you may be eligible for protections under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Additionally, since the facility offers a prompt-pay discount for upfront payment, you should contact the billing department prior to scheduling your visit to confirm the exact self-pay rate and any available discounts, ensuring you do not inadvertently trigger