X-ray, ankle
Facility: Memorial Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $394
- Cash Discount Price: $716
- vs. Medicare Baseline: 4.43x 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 443% of the Medicare baseline (a markup of 343%). 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 | $147 | 165% |
| Humana | $358 | 403% |
| Tricare | $358 | 403% |
| Medicare (plans) | $362 | 407% |
| Ambetter / Centene | $394 | 443% |
| Coventry - All Other Plans | $645 | 725% |
| Health Partners Of Kansas - All Plans | $680 | 765% |
| Preferred Healthcare-All Plans | $680 | 765% |
| Wppa/Providers Care-All Plans | $1,003 | 1128% |
Consumer Guidance & Cost Commentary
For this X-ray of the ankle at Memorial Hospital in Abilene, KS, the cash price is $716.00, which matches the facility's median paid amount. While the facility is a Critical Access Hospital owned by a Government Hospital District, the negotiated rates vary significantly by insurer, ranging from $147 with Blue Cross Blue Shield to $1,003 with Wppa/Providers Care. The median negotiated rate across all payers is $394.00, and the lowest allowed amount is $147.00. Because commercial negotiated rates often include administrative overhead and contract markups, paying cash upfront can sometimes result in a lower total cost than what your insurance plan would allow, particularly if your deductible has not yet been met.
To ensure you are receiving the most accurate pricing, it is important to distinguish between the facility's gross charges and the actual amounts paid. The Medicare benchmark for this service is $88.91, which serves as a baseline for evaluating the facility's pricing structure; the cash price of $716.00 represents a significant markup over this federal rate. If you receive a bill after using insurance, you should request an itemized billing audit to verify that no services were double-billed or unbundled, as over 80% of hospital bills contain errors. Additionally, if you are concerned about balance billing from out-of-network providers, remember that the No Surprises Act protects you from being billed the difference between the facility's chargemaster and your insurance allowed amount for emergency care or non-emergency services at in-network facilities.