X-ray, ankle
Facility: Children'S Mercy South
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $385
- Cash Discount Price: $151
- vs. Medicare Baseline: 4.33x 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 433% of the Medicare baseline (a markup of 333%). 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 |
|---|---|---|
| UnitedHealthcare | $7 - $599 | 8% |
| Medicaid / KanCare | $8 - $57 | 9% |
| Healthy Blue | $8 - $226 | 9% |
| Cigna | $8 - $619 | 9% |
| Home State Health | $8 - $198 | 9% |
| Health Midwest Comprehensive Care | $11 - $580 | 12% |
| Wppa Providrs Care | $11 - $579 | 12% |
| Healthlink | $11 - $784 | 12% |
| Quiktrip | $12 - $580 | 13% |
| American Healthcare Alliance | $12 - $757 | 13% |
| Blue Cross Blue Shield | $13 - $659 | 15% |
| Medica | $15 - $519 | 17% |
| Multiplan | $15 - $677 | 17% |
| Aetna | $15 - $606 | 17% |
| Nebraska Furniture Mart | $16 - $579 | 18% |
| Wellfit/Centrus | $16 - $579 | 18% |
| Centivo | $16 - $579 | 18% |
| Orscheln | $17 - $579 | 19% |
| Humana | $17 - $593 | 19% |
| Mercy Health | $18 - $668 | 20% |
| Coxhealth Network | $18 - $659 | 20% |
| Coventry Health Care Of Kansas | $19 - $659 | 21% |
| National Preferred Provider Network | $22 - $802 | 25% |
Consumer Guidance & Cost Commentary
For the X-ray, ankle procedure (CPT 73610), Children's Mercy South in Overland Park, KS, lists a cash price of $151.00, which is significantly lower than the facility's gross charge of $315.00. While the facility's negotiated rates for various payers range from $7 to $802, the cash price remains the most transparent baseline for patients. It is important to note that for patients with high-deductible plans, paying the cash price upfront can sometimes be more cost-effective than relying on insurance, especially if the insurer's negotiated rate exceeds the cash amount. Additionally, patients should proactively inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative fees associated with insurance claims processing.
When evaluating this cost, it is crucial to compare rates against objective benchmarks rather than the inflated chargemaster list. The Medicare benchmark for this service is $88.91, which serves as a scientifically validated baseline for the true cost of care. Although the data does not provide specific state or county average figures for comparison, the facility's cash rate of $151.00 represents a reasonable market position relative to the Medicare standard. Patients should be aware that commercial negotiated rates often include administrative markups and can vary widely between insurers; therefore, verifying the specific allowed amount with your insurance provider before scheduling is essential to avoid unexpected costs.