X-ray, ankle
Facility: William Newton Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $92
- Cash Discount Price: $190
- vs. Medicare Baseline: 1.03x 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.
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 |
|---|---|---|
| Triwest- All Plans | $66 | 74% |
| Ambetter / Centene | $68 - $190 | 76% |
| UnitedHealthcare | $68 - $171 | 76% |
| Blue Cross Blue Shield | $68 - $132 | 76% |
| Providrs Care Nexus | $116 | 130% |
| Providrs Care - All Other Plans | $133 | 150% |
Consumer Guidance & Cost Commentary
For this X-ray of the ankle at William Newton Hospital in Winfield, KS, the cash price is $190.00, which matches the facility's median negotiated rate and the cash median. This service is billed under CPT code 73610, and while the facility is a Critical Access Hospital with government ownership, the cash price is notably higher than the state average for this procedure. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates range from $66 to $190 depending on the specific plan, often exceeding the cash amount. To potentially lower costs, patients should inquire about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead and collection fees associated with insurance claims.
The Medicare benchmark for this service is $88.91, serving as a baseline to evaluate the facility's pricing markup. While the facility's cash rate of $190.00 is significantly higher than the Medicare amount, it aligns with the median paid amount of $68.00 across payers, suggesting that the negotiated rates vary widely among the six participating insurers. It is important to note that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though patients should verify their network status to avoid unexpected charges. Before scheduling, consumers are advised to request a full itemized bill to review specific CPT codes and ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a