CMS Price Transparency Data

X-ray, foot

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $40
Cash Discount Price: $251
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Munson Healthcare Otsego Memorial Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $251. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.45x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$251

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $251 (282%)

Insurance Median: $40 (45%)

Cash: $251 (282% of Medicare)

Ins. Median: $40 (45% 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 - $184	6%
Mclaren Health Plan	$5 - $247	6%
Meridian	$5 - $45	6%
Molina	$5 - $94	6%
Priority Health	$5 - $89	6%
UnitedHealthcare	$5 - $236	6%
Aetna	$8 - $239	9%
Blue Care Network	$8 - $87	9%
Hap (Health Alliance Plan)	$8 - $236	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 - $236	13%
Cigna	$12 - $89	13%
Employee Benefit Logistics	$13 - $147	15%
Nomi Health	$13 - $236	15%
Munson Hospice	$148 - $852	166%
Hospice Of Michigan	$177	199%
Enterprise Group Planning/Employee Benefit Plan	$236	265%
Cofinity	$251	282%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$251	282%
Three Rivers Provider Network	$251	282%

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 $251.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73630.

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 73630.
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.