X-ray, foot
Facility: Children'S Mercy South
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $358
- Cash Discount Price: $140
- vs. Medicare Baseline: 4.03x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 403% of the Medicare baseline (a markup of 303%). 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 |
|---|---|---|
| Healthy Blue | $7 - $226 | 8% |
| Medicaid / KanCare | $7 - $57 | 8% |
| UnitedHealthcare | $7 - $556 | 8% |
| Cigna | $8 - $575 | 9% |
| Wppa Providrs Care | $10 - $538 | 11% |
| Home State Health | $10 - $198 | 11% |
| Healthlink | $10 - $729 | 11% |
| American Healthcare Alliance | $11 - $704 | 12% |
| Health Midwest Comprehensive Care | $11 - $539 | 12% |
| Quiktrip | $12 - $539 | 13% |
| Blue Cross Blue Shield | $13 - $613 | 15% |
| Medica | $14 - $483 | 16% |
| Wellfit/Centrus | $15 - $538 | 17% |
| Aetna | $15 - $563 | 17% |
| Multiplan | $15 - $629 | 17% |
| Humana | $16 - $551 | 18% |
| Orscheln | $16 - $538 | 18% |
| Nebraska Furniture Mart | $16 - $538 | 18% |
| Centivo | $16 - $538 | 18% |
| Mercy Health | $18 - $621 | 20% |
| Coxhealth Network | $18 - $613 | 20% |
| Coventry Health Care Of Kansas | $19 - $613 | 21% |
| National Preferred Provider Network | $21 - $745 | 24% |
Consumer Guidance & Cost Commentary
For the X-ray of the foot (CPT 73630) at Children's Mercy South in Overland Park, KS, the facility's cash price of $140.00 is significantly lower than the gross chargemaster rate of $292.00. While the facility's negotiated rates with insurance payers range from $7 to $745, the cash price offers a substantial alternative for patients who may not have insurance or have high-deductible plans. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; therefore, paying out-of-pocket can sometimes result in lower out-of-pocket costs compared to insurance reimbursement. Patients should verify their specific plan's deductible status and ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final amount owed.
When evaluating the cost of this service, it is more accurate to compare rates against the Medicare benchmark rather than the facility's inflated list price. The Medicare amount for this procedure is $88.91, which serves as a scientifically validated baseline for the true cost of care. The facility's cash rate of $140.00 represents a markup of 4.0 times the Medicare amount, which falls within the range of typical commercial pricing dynamics where negotiated rates often average 200% to 300% of Medicare. If a patient receives care from an out-of-network provider, they may face balance billing for the difference between the allowed amount and the full charge, though the No Surprises Act provides protections for emergency and non-emergency services at in-network facilities. To avoid unexpected costs,