X-ray, ankle
Facility: St Luke Hospital & Living Center
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $179
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.01x 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 201% of the Medicare baseline (a markup of 101%). 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 |
|---|---|---|
| Va Ccn | $178 | 200% |
| UnitedHealthcare | $178 | 200% |
| Bluestem Pace | $178 | 200% |
| Humana | $178 | 200% |
| Blue Cross Blue Shield | $178 | 200% |
| Kansas Department Of Health And Environment | $178 | 200% |
| Ambetter / Centene | $180 | 202% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610), St Luke Hospital & Living Center in Marion, KS, has a gross charge of $350.00. While the facility is a Critical Access Hospital owned by a Government Hospital District, the negotiated rates across seven payers range from $178.00 to $180.00, with a median negotiated amount of $179.00. This negotiated rate is significantly higher than the Medicare benchmark of $88.91, reflecting the administrative costs and contract structures inherent in commercial insurance billing. For patients with high-deductible plans, the cash price may be more advantageous, as paying out-of-pocket could bypass the higher negotiated rates charged to insured members.
The facility is located in Marion, KS (ZIP 66861), and while specific county or state average data was not provided in the report, the wide variation in payer rates suggests that individual plan contracts can differ substantially. Patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, but it is crucial to verify network status before scheduling non-emergency care. To minimize costs, individuals should explicitly request a "self-pay" or "prompt-pay" discount prior to check-in, as hospitals often offer significant fee reductions for upfront payments that are not automatically applied when insurance is involved. Always demand a full itemized bill to ensure no unbundled codes or services not rendered are included in the final charge.