CMS Price Transparency Data

X-ray, foot

Facility: Golden Valley Memorial Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $88
  • Cash Discount Price: $202
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Golden Valley Memorial Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.99x the Medicare baseline. Located in 1600 N 2Nd St, Clinton, MO.
Cash / Self-Pay
$202

Average discount available for prompt cash payment at this facility.

Insurance Median
$88

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: $202 (227%)
Insurance Median: $88 (99%)
Cash: $202 (227% of Medicare)
Ins. Median: $88 (99% 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.

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
Home State Health $81 91%
UnitedHealthcare $81 - $150 91%
Aetna $88 99%
Humana $88 99%
Ambetter / Centene $106 119%

Consumer Guidance & Cost Commentary

For this X-ray of the foot at Golden Valley Memorial Hospital in Clinton, Missouri, the cash payment rate of $202 is significantly lower than the facility's gross charge of $336, representing a substantial discount for self-pay patients. While the facility's negotiated rate with UnitedHealthcare is $150, the cash price remains the most affordable option available, which is particularly beneficial for individuals with high-deductible plans who may not yet have met their insurance thresholds. It is important to note that commercial rates often exceed cash prices due to administrative overhead and contract structures, making direct payment a strategic choice to minimize out-of-pocket costs before the deductible is reached.

The facility's cash rate of $202 is notably higher than the state average for this procedure, which is $106, though it remains well below the gross chargemaster list price. Patients should be aware that while the No Surprises Act protects against balance billing for emergency services at in-network facilities, it does not automatically apply to non-emergency outpatient procedures like this X-ray, and hospitals may still attempt to bill the difference between their full charge and the insurance allowed amount. To ensure you are not overcharged, request an itemized billing audit to verify that all charges correspond to services actually rendered and to identify any potential unbundling of codes. Additionally, ask the hospital registration desk specifically about "self-pay" or "prompt-pay" discounts, as paying upfront can sometimes reduce the final bill further than the standard cash rate listed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 N 2Nd St, Clinton, MO 64735
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals