X-ray, ankle
Facility: Smith County Memorial Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $231
- Cash Discount Price: $246
- vs. Medicare Baseline: 2.60x 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 260% of the Medicare baseline (a markup of 160%). 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 | 155% |
| Medicaid / KanCare | $172 - $246 | 193% |
| Multiplan-All Plans | $221 | 249% |
| Wppa-All Plans | $231 | 260% |
| UnitedHealthcare | $234 | 263% |
| Midlands Choice-All Plans | $234 | 263% |
| Health Partners Of Ks Ppo-All Plans | $234 | 263% |
Consumer Guidance & Cost Commentary
For this X-ray of the ankle at Smith County Memorial Hospital in Smith Center, KS, the cash price is $246.00, which matches the facility's gross chargemaster rate. While the median amount paid by insurance plans is $231.00, patients with high-deductible plans may find paying the cash price directly more affordable, as the negotiated rates from insurers like Medicaid/KanCare and UnitedHealthcare do not exceed the cash amount. It is important to note that while the facility is a Critical Access Hospital with government-local ownership, the cash rate remains at the full list price, meaning no automatic discount is applied simply by having insurance.
When evaluating costs, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster. The Medicare allowed amount for this procedure is $88.91, and the commercial negotiated rates average approximately 260% of the Medicare rate, which is significantly higher than the typical fair pricing range of 120% to 150%. Although the data does not provide specific county or state average comparisons for this code, patients should be aware that commercial rates often include administrative overhead that can inflate the baseline price. To potentially lower costs, patients should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full upfront, and request an itemized bill to ensure no errors or unbundled charges are included.