CMS Price Transparency Data

X-ray, ankle

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $55
Cash Discount Price: $269
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Munson Healthcare Otsego Memorial Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $269. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.62x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$269

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $269 (303%)

Insurance Median: $55 (62%)

Cash: $269 (303% of Medicare)

Ins. Median: $55 (62% 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
Blue Cross Blue Shield	$5 - $214	6%
Mclaren Health Plan	$5 - $287	6%
Meridian	$5 - $45	6%
Molina	$5 - $94	6%
Priority Health	$5 - $96	6%
UnitedHealthcare	$5 - $274	6%
Aetna	$8 - $277	9%
Blue Care Network	$8 - $87	9%
Hap (Health Alliance Plan)	$8 - $274	9%
Humana	$8 - $87	9%
Medicare (plans)	$8 - $87	9%
Michigan Amish Medical Board	$8 - $87	9%
Northern Michigan Mennonite Group	$8 - $87	9%
Asr Physicians Care Network	$12 - $274	13%
Cigna	$13 - $96	15%
Nomi Health	$13 - $274	15%
Employee Benefit Logistics	$14 - $147	16%
Munson Hospice	$146 - $852	164%
Hospice Of Michigan	$175 - $205	197%
Enterprise Group Planning/Employee Benefit Plan	$233 - $274	262%
Cofinity	$247 - $291	278%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$247 - $291	278%
Three Rivers Provider Network	$247 - $291	278%

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 $269.
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 Munson Healthcare Otsego Memorial Hospital 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.