CMS Price Transparency Data

X-ray, ankle

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $111
Cash Discount Price: $319
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at UMass Memorial Healthalliance Hospitals is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.25x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$319

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $319 (359%)

Insurance Median: $111 (125%)

Cash: $319 (359% of Medicare)

Ins. Median: $111 (125% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Workers Compensation [20501]	$27	30%
Champva [11001]	$94	106%
Wellpoint [11112]	$94	106%
Institution [10406]	$104 - $169	117%
Medicare (plans)	$104 - $106	117%
Tufts Dual [10111]	$104 - $106	117%
Cigna	$106 - $278	119%
Correctional Care [11003]	$106	119%
Medicaid / KanCare	$106 - $166	119%
Tufts Us Family [11203]	$106	119%
Blue Cross Blue Shield	$108 - $115	121%
UnitedHealthcare	$108 - $319	121%
Aetna	$110 - $209	124%
Commonwealth Care Mcr [10115]	$110 - $111	124%
Fallon Mcr Supp [20202]	$110 - $111	124%
Mgb Mcr [10124]	$110 - $111	124%
Tufts Mcr [10112]	$110 - $111	124%
Harvard Pilgrim Mcr [10106]	$111	125%
Senior Whole Health [10110]	$113	127%
Harvard Pilgrim [10701]	$130 - $156	146%
Fallon Connectorcare [10503]	$152	171%
Tufts Connectorcare [10507]	$177 - $180	199%
Hne [11108]	$178	200%
Tufts [11201]	$226	254%
First Health Network [11120]	$239	269%
Multiplan [11109]	$239	269%
Hsno/Free Care [10801]	$294	331%
Connecticare [11105]	$319	359%
Fallon Carelon Hlth [28]	$319	359%
Fallon Mcaid Carelon Hlth [29]	$319	359%
Grants [20507]	$319	359%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $319.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UMass Memorial Healthalliance Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.